Henriques Mendes Marina, Guimarães André, Dahlstedt Ferreira Catrine, Carneiro Fátima, Santos Lurdes
Internal Medicine, Centro Hospitalar Tâmega e Sousa, Penafiel, PRT.
Infectious Diseases, Centro Hospitalar de São João, Porto, PRT.
Cureus. 2023 Dec 12;15(12):e50407. doi: 10.7759/cureus.50407. eCollection 2023 Dec.
Intravesical instillation of bacillus Calmette-Guérin (BCG) is a crucial adjunctive therapy in the treatment of bladder carcinoma. Its systemic complications are rare but include disseminated () infections, the diagnosis of which is a challenging task that requires keen clinical awareness. We report the case of an adult male treated with BCG who presented with fever, nonspecific constitutional symptoms, hepatic cytolysis, and cholestasis. After a detailed workup, the diagnosis was made of disseminated infection with hepatic, pulmonary, renal, and ureteral involvement. Prompt anti-tuberculosis treatment resulted in clinical and analytical improvement. This case highlights the importance of early recognition of this serious complication in patients with BCG exposure, as well as the difficulty in confirming the diagnosis for proper treatment.
膀胱内灌注卡介苗（BCG）是膀胱癌治疗中的关键辅助疗法。其全身并发症罕见，但包括播散性（）感染，对此类感染的诊断是一项具有挑战性的任务，需要敏锐的临床意识。我们报告一例接受卡介苗治疗的成年男性病例，该患者出现发热、非特异性全身症状、肝细胞溶解和胆汁淤积。经过详细检查，诊断为播散性感染，累及肝脏、肺、肾和输尿管。及时的抗结核治疗使临床和分析结果得到改善。该病例强调了早期识别卡介苗暴露患者中这种严重并发症的重要性，以及确诊以便进行适当治疗的困难。
