Berneri Massimo, Murray Fionnuala, Davel Sue
Joondalup Health Campus, Cnr Grant Blvd &, Shenton Ave, Joondalup, WA 6027, Australia.
St John of God Hospital Subiaco, WA 6008, Australia.
IDCases. 2023 Apr 26;32:e01773. doi: 10.1016/j.idcr.2023.e01773. eCollection 2023.
Bacillus Calmette-Guérin (BCG), a live attenuated strain of Mycobacterium bovis was first described as a vaccine against tuberculosis in 1921. The use of intravesical BCG to treat non-muscle invasive bladder cancer (NMIBC) was first described by Morales in 1921. The therapeutic effect of BCG is related to stimulation of the immune system following direct contact with tumour cells. As a result of this intended immune response some minor symptoms including fever, malaise and bladder irritation manifesting as dysuria, urinary frequency and mild haematuria, are expected. These side effects are however, generally easily managed and well tolerated. Severe complications are rare and can be temporally remote from the instillation of therapy. In this report we describe the case of a 74-year-old immunocompetent man with biopsy confirmed BCG T11/12 discitis and adjacent osteomyelitis of the T11/T12 vertebral bodies with an associated an epidural abscess following intravesical administration of BCG therapy for recurrent bladder transitional cell carcinoma (TCC).
卡介苗（BCG）是一种减毒活牛分枝杆菌菌株，于1921年首次被描述为一种抗结核疫苗。1921年，莫拉莱斯首次描述了膀胱内灌注卡介苗治疗非肌层浸润性膀胱癌（NMIBC）。卡介苗的治疗效果与直接接触肿瘤细胞后刺激免疫系统有关。由于这种预期的免疫反应，预计会出现一些轻微症状，包括发热、不适以及膀胱刺激症状，如排尿困难、尿频和轻度血尿。然而，这些副作用通常易于处理且耐受性良好。严重并发症很少见，并且可能在治疗灌注后很长时间才出现。在本报告中，我们描述了一例74岁免疫功能正常的男性病例，该患者经活检确诊为卡介苗引起的T11/12椎间盘炎及相邻的T11/T12椎体骨髓炎，并在膀胱内灌注卡介苗治疗复发性膀胱移行细胞癌（TCC）后出现了硬膜外脓肿。
