Felix E L, Jessup J M, Cohen M H
Arch Surg. 1978 Jul;113(7):893-6. doi: 10.1001/archsurg.1978.01370190115025.
Since the introduction of BCG intralesional immunotherapy for melanoma, severe complications, including death, have been reported after treatment in hypersensitized individuals. This is a case report of BCG dissemination with ulceration, skin necrosis, lymphadenitis, and abscess formation following the first intralesional injection of a minimal dose of BCG in a PPD-negative patient. The case demonstrates that severe complications can occur in patients who are not hypersensitized, anergic, or debilitated or who have been treated multiple times. This patient's complication further suggests that migration of BCG after intralesional therapy may play a role in the regression of uninjected nodules seen in some patients.
自从将卡介苗病灶内免疫疗法用于黑色素瘤治疗以来，已有报告称超敏个体在治疗后出现包括死亡在内的严重并发症。本文报告了一例在PPD阴性患者首次病灶内注射最小剂量卡介苗后发生卡介苗播散，并伴有溃疡、皮肤坏死、淋巴结炎和脓肿形成的病例。该病例表明，在未发生超敏反应、无变应性或身体虚弱以及未接受过多次治疗的患者中也可能出现严重并发症。该患者的并发症进一步表明，病灶内治疗后卡介苗的迁移可能在部分患者未注射结节的消退过程中发挥作用。
