PDF(Pubmed)
Abstract：
Intravesical therapy with Bacillus Calmette-Guerin (BCG) is the mainstay treatment for high-risk non-muscle invasive bladder cancer. The side effects are usually local and mild. Systemic dissemination of BCG is rare, typically develops soon after instillation, and may present as a severe life-threatening condition. We present a case of a 49-year-old man under chronic haemodialysis who developed septic shock after the first BCG maintenance instillation for bladder carcinoma in situ (CIS). Supportive measures and empiric broad-spectrum antibiotic therapy were promptly started after sample collection for cultures. Lastly, the recurrence of fever raised the initial suspicion of BCG dissemination. The diagnosis was confirmed by the identification of the Mycobacterium tuberculosis complex in blood samples collected and anti-tuberculosis therapy was then initiated. We would like to highlight the need for early recognition of a systemic BCG infection and the importance of starting anti-tuberculosis treatment as early as possible.
摘要：
卡介苗（BCG）的膀胱内治疗是高危非肌肉浸润性膀胱癌的主要治疗方法。副作用通常是局部和轻微的。BCG的系统性传播很少见，通常在滴注后不久发展，并可能表现为严重的危及生命的状况。我们介绍了一例49岁的慢性血液透析患者，该患者在首次进行BCG维持滴注治疗原位膀胱癌（CIS）后出现感染性休克。收集培养样品后，立即开始支持性措施和经验性广谱抗生素治疗。最后,发烧的复发增加了最初对BCG传播的怀疑。通过在收集的血液样品中鉴定结核分枝杆菌复合体来确认诊断，然后开始抗结核治疗。我们想强调早期识别全身性BCG感染的必要性以及尽早开始抗结核治疗的重要性。
