Harada Hiroshi, Seki Masaaki, Shinojima Hirokazu, Miura Masayoshi, Hirano Tetsuo, Togashi Masaki
Department of Urology, Sapporo City General Hospital, Sapporo, Japan.
Int J Urol. 2006 Feb;13(2):183-5. doi: 10.1111/j.1442-2042.2006.01257.x.
The intravesical instillation of bacillus Calmette-Guérin (BCG) is a standard therapy for superficial bladder carcinoma. Tuberculosis-like inflammation in the genitourinary tract is a serious complication of BCG. It can occur after a long interval from the cessation of the intravesical BCG therapy. If inflammation occurs, it is necessary to test whether the BCG strain has caused it or another mycobacterium species has. However, there has never been a report that proves BCG causes the inflammation, because BCG is difficult to differentiate from other strains of Mycobacterium bovis and other members of the Mycobacterium tuberculosis complex by conventional tests, including regular polymerase chain reaction (PCR). We first present a case of epididymo-orchitis, which developed 31 months after the cessation of BCG therapy, detected using a multiplex PCR method as having been caused by BCG. Our report illustrates the efficacy of this method to detect the responsible microbe that is thought to be transmitted from the instillated BCG strain.
膀胱内灌注卡介苗（BCG）是浅表性膀胱癌的标准治疗方法。卡介苗引起的泌尿生殖道结核样炎症是卡介苗治疗的严重并发症。它可能在膀胱内卡介苗治疗停止很长一段时间后发生。如果发生炎症，有必要检测是卡介苗菌株还是其他分枝杆菌属引起的。然而，从未有报告证明卡介苗会导致炎症，因为通过常规检测，包括常规聚合酶链反应（PCR），卡介苗很难与牛分枝杆菌的其他菌株以及结核分枝杆菌复合群的其他成员区分开来。我们首次报告了一例附睾炎，发生在卡介苗治疗停止31个月后，通过多重PCR方法检测发现是由卡介苗引起的。我们的报告说明了这种方法在检测被认为是由灌注的卡介苗菌株传播的致病微生物方面的有效性。
