PDF(Pubmed)
Abstract：
BACKGROUND: Intravesical Bacillus Calmette-Guerin immunotherapy is known to prevent recurrence of bladder cancer, but it can cause tuberculosis infections as an adverse event.
METHODS: A 75-year-old man visited our hospital due to hematuria. The patient was diagnosed with bladder cancer and underwent transurethral resection of the bladder tumor. Postoperatively, the patient received Bacillus Calmette-Guerin immunotherapy. One year later, we performed transurethral surgery and prostate biopsy because of cystoscopic findings showing nodulous lesions in the bladder and an elevated serum prostate-specific antigen level. The patient presented with high fever and malaise since the surgery. After careful examination, the patient was diagnosed with miliary tuberculosis caused by Mycobacterium bovis. The pathology of the bladder and prostate revealed acid-fast bacilli collection by Ziehl-Neelsen staining.
CONCLUSIONS: The surgery exacerbated the local infection into a systemic infection. The risk of developing miliary tuberculosis should be considered at transurethral surgery or prostate biopsy in patients after intravesical Bacillus Calmette-Guerin immunotherapy.
METHODS: A 75-year-old man visited our hospital due to hematuria. The patient was diagnosed with bladder cancer and underwent transurethral resection of the bladder tumor. Postoperatively, the patient received Bacillus Calmette-Guerin immunotherapy. One year later, we performed transurethral surgery and prostate biopsy because of cystoscopic findings showing nodulous lesions in the bladder and an elevated serum prostate-specific antigen level. The patient presented with high fever and malaise since the surgery. After careful examination, the patient was diagnosed with miliary tuberculosis caused by Mycobacterium bovis. The pathology of the bladder and prostate revealed acid-fast bacilli collection by Ziehl-Neelsen staining.
CONCLUSIONS: The surgery exacerbated the local infection into a systemic infection. The risk of developing miliary tuberculosis should be considered at transurethral surgery or prostate biopsy in patients after intravesical Bacillus Calmette-Guerin immunotherapy.
摘要：
背景：膀胱内卡介苗（BacillusCalmette-Guerin）免疫治疗可预防膀胱癌复发，但它可以作为不良事件引起结核病感染。
方法：一名75岁男性因血尿到我院就诊。患者被诊断为膀胱癌，并接受了经尿道膀胱肿瘤切除术。术后,患者接受了卡介苗-格林杆菌免疫治疗.一年后,我们进行了经尿道手术和前列腺活检,因为膀胱镜检查结果显示膀胱结节状病变和血清前列腺特异性抗原水平升高.自手术以来，患者出现高烧和不适。经过仔细检查,该患者被诊断为由牛分枝杆菌引起的粟粒性结核。膀胱和前列腺的病理显示通过Ziehl-Neelsen染色收集了抗酸杆菌。
结论：手术将局部感染加重为全身感染。在膀胱内接受卡介苗（BacillusCalmette-Guerin）免疫治疗的患者中，应在经尿道手术或前列腺活检时考虑发展为粟粒性结核的风险。
方法：一名75岁男性因血尿到我院就诊。患者被诊断为膀胱癌，并接受了经尿道膀胱肿瘤切除术。术后,患者接受了卡介苗-格林杆菌免疫治疗.一年后,我们进行了经尿道手术和前列腺活检,因为膀胱镜检查结果显示膀胱结节状病变和血清前列腺特异性抗原水平升高.自手术以来，患者出现高烧和不适。经过仔细检查,该患者被诊断为由牛分枝杆菌引起的粟粒性结核。膀胱和前列腺的病理显示通过Ziehl-Neelsen染色收集了抗酸杆菌。
结论：手术将局部感染加重为全身感染。在膀胱内接受卡介苗（BacillusCalmette-Guerin）免疫治疗的患者中，应在经尿道手术或前列腺活检时考虑发展为粟粒性结核的风险。
