Geerdes-Fenge Hilte Friederike, Stubbe Franziska, Löbermann Micha, Warnke Philipp, Erbersdobler Andreas, Reisinger Emil Christian
Abteilung für Tropenmedizin und Infektionskrankheiten und Sektion Nephrologie, Universitätsmedizin Rostock.
Abteilung für Hämatologie, Universitätsmedizin Rostock.
Dtsch Med Wochenschr. 2017 Sep;142(18):1375-1378. doi: 10.1055/s-0043-115775. Epub 2017 Sep 8.
A 77-year-old patient with transurethral resection of a bladder tumor was transferred due to persistent fever and progressive dyspnea despite antibiotic therapy for suspected urinary tract infection. Repeating the medical history revealed that a BCG immunotherapy of his non-muscle-invasive bladder carcinoma was performed the day before fever developed. Therefore, BCGitis was suspected. Laboratory parameters showed pancytopenia, elevated liver enzymes, eleveated C-reactive protein and hypoxemia. The CT scan showed multiple miliary lesions of the lung, the bone marrow biopsy revealed granuloma. M. bovis BCG was cultured from urine and bronchoalveolar lavage fluid. Therapy with isoniazide, rifampine, ethambutol and initially prednisolone caused rapid improvement. BCGitis is a rare complication of BCG immunotherapy of non-muscle-invasive bladder carcinoma.
一名77岁经尿道膀胱肿瘤切除术患者，尽管针对疑似尿路感染进行了抗生素治疗，但仍因持续发热和进行性呼吸困难而被转诊。再次询问病史发现，在发热前一天对其非肌层浸润性膀胱癌进行了卡介苗免疫治疗。因此，怀疑是卡介苗性膀胱炎。实验室检查参数显示全血细胞减少、肝酶升高、C反应蛋白升高和低氧血症。CT扫描显示肺部有多个粟粒状病变，骨髓活检发现肉芽肿。从尿液和支气管肺泡灌洗液中培养出牛型结核分枝杆菌卡介苗。异烟肼、利福平、乙胺丁醇及最初使用的泼尼松龙治疗后病情迅速改善。卡介苗性膀胱炎是非肌层浸润性膀胱癌卡介苗免疫治疗的一种罕见并发症。
