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[卡介苗膀胱内灌注诱发间质性肺炎病例]

[Case of interstitial pneumonia induced by intravesical administration of Bacillus Calmette-Guerin].

作者信息

Yamamoto Akihito, Koyama Ryo, Kido Kenji, Koike Kengo, Toba Michie, Takahashi Kazuhisa

机构信息

Tobu Chiiki Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2008 Oct;46(10):803-7.

Abstract

An 81-year-old man with superficial bladder cancer, which was detected after he complained of hematuria and pain on urination, was treated 5 times with intravesical bacillus Calmette-Guerin (BCG) administration. Since he complained of a dry cough and dyspnea associated with severe hypoxemia, and had extensive bilateral pulmonary infiltrative shadows on his chest X-ray film, he was admitted to our hospital. He was treated with methylprednisolone under a diagnosis of interstitial pneumonia. Because BCG infection and/or bacterial pneumonia could not be denied, we administered antituberculosis agent and antibiotics. However, he died due to respiratory failure on 10th day after admission. Because a lymphocyte stimulation test for BCG was strongly positive, we established a diagnosis of interstitial pneumonia induced by intravesical administration of BCG. Because the mortality rate is high, the evaluation of interstitial pneumonia before administration of BCG is crucial.

摘要

一名81岁男性,因出现血尿和排尿疼痛后被诊断为浅表性膀胱癌,接受了5次膀胱内卡介苗(BCG)灌注治疗。由于他主诉干咳和呼吸困难并伴有严重低氧血症,胸部X线片显示双侧肺部有广泛浸润性阴影,遂入住我院。他被诊断为间质性肺炎并接受甲基强的松龙治疗。由于不能排除卡介苗感染和/或细菌性肺炎,我们给予了抗结核药物和抗生素治疗。然而,他在入院后第10天因呼吸衰竭死亡。由于卡介苗淋巴细胞刺激试验呈强阳性,我们确诊为膀胱内灌注卡介苗引起的间质性肺炎。鉴于死亡率较高,在卡介苗灌注前对间质性肺炎进行评估至关重要。

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