双刃剑 - 膀胱癌卡介苗治疗后人工关节感染：病例报告。
The double-edged sword - prosthetic joint infection following BCG treatment for bladder cancer: a case report.
机构信息
University of California Davis Medical Center, Sacramento, CA, USA.
Department of Orthopedics, University of California Davis Medical Center, Sacramento, CA, USA.
出版信息
BMC Infect Dis. 2019 Apr 18;19(1):331. doi: 10.1186/s12879-019-3951-1.
BACKGROUND
Prosthetic joint infections remain a significant cause of morbidity and are frustrating for patients and physicians alike. Unusual causes of infection may be seen in selected circumstances and a high index of suspicion and a careful history are required to ensure an accurate and timely diagnosis can be made.
CASE PRESENTATION
We present a case of Mycobacterium bovis prosthetic joint infection secondary to intravesicular Bacillus Calmette-Guérin (BCG) treatment for prior bladder cancer definitively identified by spoligotyping. A favorable clinical outcome was observed following surgical intervention and a 12-month course of anti-mycobacterial therapy.
CONCLUSIONS
BCG therapy, a live attenuated strain of M. bovis, has become the mainstay of adjunctive therapy for bladder cancer and infectious complications, including those affecting the musculoskeletal system, may be seen years after initial therapy. An awareness of this complication and appropriate discussions with the institution's microbiology laboratory may allow for an accurate and timely identification.
背景
人工关节感染仍然是发病率的一个重要原因，对患者和医生来说都感到沮丧。在特定情况下可能会出现感染的不常见原因，需要高度怀疑和仔细的病史，以确保能够做出准确和及时的诊断。
病例介绍
我们提出了一例继发于膀胱内卡介苗（BCG）治疗的牛分枝杆菌人工关节感染的病例，先前的膀胱癌经 spoligotyping 明确诊断。在手术干预和为期 12 个月的抗分枝杆菌治疗后，观察到了良好的临床结果。
结论
BCG 治疗是一种减毒的牛分枝杆菌活疫苗，已成为膀胱癌辅助治疗的主要方法，包括影响肌肉骨骼系统在内的感染并发症可能在初始治疗多年后出现。对这种并发症的认识以及与机构微生物实验室的适当讨论，可能有助于准确和及时的识别。
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