Branco Elsa Alves, Duro Raquel, Brito Teresa, Sarmento António
Infectious Diseases Department, Centro Hospitalar e Universitário de São João, 4099-002 Porto, Portugal.
Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4099-002 Porto, Portugal.
Infect Dis Rep. 2021 Jul 1;13(3):611-618. doi: 10.3390/idr13030057.
Intra-vesical instillation of bacillus Calmette-Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.
膀胱内灌注卡介苗（BCG）是浅表性膀胱癌的一种重要治疗方式。尽管可能会出现一些不良反应，但通常耐受性良好。一种可能但罕见的并发症是肉芽肿性肝炎，被认为是由卡介苗感染或对该杆菌的过敏反应引起的。我们报告一例79岁的免疫功能正常患者，在接受卡介苗膀胱肿瘤免疫治疗几个月后发生了肉芽肿性肝炎。需要注意的是，抗酸涂片和培养结果通常为阴性，这些不应排除诊断或延误治疗。我们的病例强调了临床怀疑和及时开始适当治疗的重要性。
