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肉芽肿性肝炎、脉络膜炎和腹主动脉-十二指肠瘘并发膀胱卡介苗治疗：病例报告。

Granulomatous hepatitis, choroiditis and aortoduodenal fistula complicating intravesical Bacillus Calmette-Guérin therapy: Case report.

机构信息

Division of Gastroenterology, Hepatology and Nutrition, Loyola University Medical Center, 2160 South 1st Avenue, Maywood, IL 60153, USA.

出版信息

BMC Infect Dis. 2011 Sep 30;11:260. doi: 10.1186/1471-2334-11-260.

DOI:10.1186/1471-2334-11-260
PMID:21961922
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3193172/
Abstract

BACKGROUND

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is the treatment of choice for superficial bladder carcinoma. Complications of BCG therapy include local infections and disseminated BCG infection with multiple endorgan complications.

CASE PRESENTATION

We report a case of disseminated, post-treatment BCG infection that initially presented with granulomatous hepatitis and choroiditis. After successful anti-mycobacterial therapy and resolution of the hepatic and ocular abnormalities, the patient developed an acute upper gastrointestinal hemorrhage from an aortoduodenal fistula that required emergency surgery. The resection specimen revealed multifocal, non-caseating granulomas, indicating mycobacterial involvement.

CONCLUSIONS

This case highlights the varied end organ complications of disseminated BCG infection, and the need for vigilance even in immuno-competent patients with a history of intravesical BCG treatment.

摘要

背景

卡介苗（BCG）膀胱内灌注是治疗表浅膀胱癌的首选方法。BCG 治疗的并发症包括局部感染和播散性 BCG 感染以及多个终末器官并发症。

病例介绍

我们报告了一例播散性、治疗后 BCG 感染的病例，最初表现为肉芽肿性肝炎和脉络膜炎。在成功进行抗分枝杆菌治疗并解决肝脏和眼部异常后，患者发生了急性上消化道出血，病因是主动脉-十二指肠瘘，需要紧急手术。切除标本显示多灶性、非干酪样肉芽肿，表明存在分枝杆菌感染。

结论

本病例强调了播散性 BCG 感染的各种终末器官并发症，即使对于有膀胱内 BCG 治疗史的免疫功能正常患者，也需要保持警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/63a018424beb/1471-2334-11-260-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/405cdcc5f601/1471-2334-11-260-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/f681806ed463/1471-2334-11-260-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/7b49e2043165/1471-2334-11-260-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/2adcdb0c6614/1471-2334-11-260-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/63a018424beb/1471-2334-11-260-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/405cdcc5f601/1471-2334-11-260-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/f681806ed463/1471-2334-11-260-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/7b49e2043165/1471-2334-11-260-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/2adcdb0c6614/1471-2334-11-260-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db36/3193172/63a018424beb/1471-2334-11-260-5.jpg

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