Fishman J R, Walton D T, Flynn N M, Benson D R, deVere White R W
Department of Urology, University of California, School of Medicine, Davis, Sacramento.
J Urol. 1993 Mar;149(3):584-7. doi: 10.1016/s0022-5347(17)36155-4.
We report a case of tuberculous spondylitis following intravesical bacillus Calmette-Guerin (BCG) instillation. A 90-year-old male physician living in South Africa received an uncomplicated 6-week course of intravesical BCG (Japanese 172 strain) for high grade superficial bladder carcinoma. He experienced a sudden onset of debilitating lower back pain 16 months following this treatment. A lytic lesion involving the anterior T11 and T12 vertebral bodies was diagnosed and subsequently biopsied. An acid-fast organism was isolated after 3 weeks of incubation and was confirmed through deoxyribonucleic acid probe hybridization as a mycobacterium. High performance liquid chromatography analysis speciated the organism as Mycobacterium bovis BCG, proving that it was acquired through the intravesical therapy.
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。一名居住在南非的90岁男性医生因高级别浅表性膀胱癌接受了为期6周的无并发症膀胱内BCG（日本172株）治疗。在该治疗16个月后，他突然出现使人衰弱的下背部疼痛。诊断出一个累及胸11和胸12椎体前部的溶骨性病变，随后进行了活检。培养3周后分离出一种抗酸菌，通过脱氧核糖核酸探针杂交确认为分枝杆菌。高效液相色谱分析将该菌鉴定为牛分枝杆菌卡介苗，证明它是通过膀胱内治疗获得的。
