PDF(Pubmed)
Abstract：
Bladder cancer significantly impacts global health, particularly non-muscle-invasive bladder cancer (NMIBC), which is typically treated with transurethral resection of bladder tumor (TURBT) and intravesical Bacillus Calmette-Guérin (BCG) therapy. While there is evidence that BCG can effectively prevent tumor recurrence and progression, it can cause adverse effects, including disseminated infection, necessitating the exclusion of active tuberculosis and the assessment of immunosuppressive conditions before treatment. We present two cases of disseminated BCG infection. The first involves an 85-year-old male who developed an abscess in his right thigh post-BCG therapy, successfully treated with isoniazid (INH), ethambutol, and rifampin. The second case is a 63-year-old male who, three years post-BCG therapy and abdominal aortic aneurysm repair, developed a right psoas abscess and a mycotic aneurysm. He was also treated with ethambutol, INH, and rifampin, in addition to surgical intervention. Effective management of BCG-related infections requires early identification of Mycobacterium bovis, a multidisciplinary approach, thorough pre-treatment evaluations, and aggressive treatment strategies, including anti-tubercular drugs and surgical intervention as necessary.
摘要：
膀胱癌严重影响全球健康，特别是非肌肉浸润性膀胱癌（NMIBC），通常采用经尿道膀胱肿瘤切除术（TURBT）和膀胱内卡介苗（BCG）治疗。虽然有证据表明卡介苗可以有效预防肿瘤复发和进展，它会造成不良影响,包括播散性感染,需要在治疗前排除活动性结核病并评估免疫抑制状况。我们介绍了两例播散性BCG感染。首先涉及一名85岁的男性，他在接受卡介苗治疗后右大腿出现脓肿，用异烟肼（INH）成功治疗，乙胺丁醇,还有利福平.第二个病例是一名63岁的男性,卡介苗治疗和腹主动脉瘤修复术后三年，发展了右腰大肌脓肿和霉菌性动脉瘤。他还接受了乙胺丁醇治疗，INH,还有利福平,除了手术干预。有效管理卡介苗相关感染需要早期识别牛分枝杆菌，多学科方法，全面的治疗前评估，积极的治疗策略，包括抗结核药物和必要的手术干预。
