在内BCG治疗后同时发生的间歇性肺炎和传播的BCG感染:一个病例报告
Fumi Mochizuki1, Midori Hanazawa1, Manabu Komine2
1Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Japan.
Internal medicine (Tokyo, Japan)
|December 18, 2024
概括
一名患者在治疗膀癌后出现发烧和肺部异常,Bacillus Calmette-Guérin (BCG). 传播的BCG感染被证实,强调在类似的情况下需要考虑这种诊断.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 肠道 Calmette-Guérin (BCG) 是一种用于非肌肉侵入性膀癌的标准治疗方法.
- 在BCG治疗后的并发症可能包括系统性感染,尽管很少见.
- 间歇性肺炎是BCG灌注后潜在的肺部表现.
研究的目的:
- 报告一种传播的BCG感染病例,在静脉BCG治疗后呈现为间歇性肺炎.
- 强调在治疗后出现肺部症状的患者考虑BCG感染的重要性.
- 突出诊断挑战和成像和微生物学分析的作用.
主要方法:
- 一个83岁的男性患者的病例介绍,BCG治疗后持续发烧.
- 诊断工作包括胸部计算机断层扫描 (CT) 和支气管支气管洗 (BAL) 的支气管镜检查.
- 进行了唾液培养和呼吸道样本分析,以检测Mycobacterium bovis BCG.
主要成果:
- 胸部CT显示了分散的地面玻璃不透明度和微块,暗示了间歇性肺炎.
- 在BAL液中,淋巴细胞占主导地位,CD4/CD8比率高.
- 在入院50天后,Mycobacterium bovis BCG最终在唾液培养物中被发现,证实了传播感染.
结论:
- 在经过静脉BCG治疗后出现异常胸部成像的患者中,应考虑同时进行间歇性肺炎和BCG感染.
- 早期识别和适当的抗结核治疗对于管理传播的BCG感染至关重要.
- 这一案例强调了在膀癌BCG免疫治疗后可能出现严重的全身并发症的可能性.
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