Nishimura Masashi, Okumura Masao, Takemasa Takii, Yoshiyama Takashi, Tanaka Yoshiaki, Saotome Mikio, Ohta Ken
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan.
Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Japan.
Respir Med Case Rep. 2023 Jul 22;45:101902. doi: 10.1016/j.rmcr.2023.101902. eCollection 2023.
Bacillus Calmette-Guerin (BCG) intravesical injections are used as adjuvant therapy for superficial bladder cancer. We report a case of a 78-year-old man who developed disseminated BCG disease mimicking miliary tuberculosis early after BCG intravesical infusion. He started coughing after receiving three rounds of BCG for superficial bladder tumors, following transurethral resection of the tumors, approximately one month after initiation. Computerized tomography (CT) images showed diffuse nodular shadows in the bilateral lung fields with a random pattern. Consequently, disseminated BCG disease was diagnosed. Treatment with isoniazid, rifampicin, and ethambutol was initiated. Nine months after initiating treatment, CT showed the disappearance of the miliary shadows. We also discussed 77 cases of suspected BCG infection and the requests for BCG identification at our institution from 2017 to October 2022. Of these, 76 cases were BCG, and 1 case was Since can be identified in some patients with suspected BCG infection, it is crucial to distinguish between the two based on pathogenicity.
卡介苗（BCG）膀胱内注射用作浅表性膀胱癌的辅助治疗。我们报告一例78岁男性，在卡介苗膀胱内灌注后早期出现类似粟粒性肺结核的播散性卡介苗病。在经尿道肿瘤切除术后，他在接受三轮卡介苗治疗浅表膀胱肿瘤后约1个月开始咳嗽，最初是因为浅表膀胱肿瘤。计算机断层扫描（CT）图像显示双肺野弥漫性结节状阴影，呈随机分布。因此，诊断为播散性卡介苗病。开始使用异烟肼、利福平及乙胺丁醇治疗。治疗9个月后，CT显示粟粒状阴影消失。我们还讨论了2017年至2022年10月在我们机构的77例疑似卡介苗感染病例及卡介苗鉴定请求。其中，76例为卡介苗，1例为……由于在一些疑似卡介苗感染患者中可以鉴定出……，基于致病性区分两者至关重要。
