Sugita Y, Chokyu H, Gotoh A, Maeda H, Umezu K, Nakano Y
Department of Urology, Kobe National Hospital.
Nihon Hinyokika Gakkai Zasshi. 1995 Sep;86(9):1493-6. doi: 10.5980/jpnjurol1989.86.1493.
We report a case of tuberculous spondylitis after intravesical bacillus Calmette-Guerin (BCG) instillation. A 71-year-old man was administered BCG (80 mg per week) for 8 weeks for prophylactic treatment of bladder cancer. After the first instillation he experienced miction pain, pollakisuria, and febrile episodes. Two months after the completion of BCG instillation, he complained to back pain and spinal X-ray showed a lytic lesion of Th7 vertebra. Diagnosis of metastatic transitional cell carcinoma was made based on MRI and bone scan. But pathological findings at laminectomy revealed tuberculous spondylitis. Antituberculous therapy (SM, RFP, and INH) was instituted and anterior supine fusion was performed. Now he is free from bladder cancer and tuberculous infection. Intravesical BCG instillation is effective for superficial bladder cancer, but it should be kept in mind that complications related to this treatment could occur and the adequate antituberculosis treatment has to be insisted if indicated.
我们报告一例膀胱内灌注卡介苗（BCG）后发生的结核性脊柱炎病例。一名71岁男性因膀胱癌预防性治疗接受BCG（每周80mg）灌注8周。首次灌注后，他出现排尿疼痛、尿频和发热发作。BCG灌注完成两个月后，他主诉背痛，脊柱X线显示第7胸椎溶骨性病变。基于MRI和骨扫描诊断为转移性移行细胞癌。但椎板切除术中的病理结果显示为结核性脊柱炎。开始抗结核治疗（链霉素、利福平、异烟肼）并进行前路仰卧位融合术。现在他已无膀胱癌和结核感染。膀胱内BCG灌注对浅表性膀胱癌有效，但应牢记可能发生与此治疗相关的并发症，如有指征必须坚持进行充分的抗结核治疗。
