[Antibioprophylaxis failure with BCG therapy for bladder neoplasia].

IF 0.5 4区医学 Q4 RESPIRATORY SYSTEM

Revue des maladies respiratoires Pub Date : 2024-12-11 DOI:10.1016/j.rmr.2024.11.004

N Argoulon, H Morel, P Lanotte, M Ferreira, T Prazuck, S Marchand-Adam

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引用次数: 0

Abstract

Introduction: BCG therapy is the standard treatment for bladder tumors that do not infiltrate smooth muscle. Fluoroquinolones for antibiotic prophylaxis are recommended to lessen the risk of BCG infection (BCGitis) with respiratory involvement.

Case report: This study describes five cases of BCGitis in males, with a median age of 71years [range: 66-77years] having undergone ofloxacin prophylaxis during their BCG therapy for a non-invasive bladder tumor (grade pT1a). Among these patients, four experienced fever within eight hours of the last instillation, as well as respiratory symptoms such as dyspnea and cough. Three of them exhibited substantial weight loss over the course of one month. Chest scans consistently revealed miliary patterns. While only in one patient was BCG identification confirmed, typical clinical and CT presentations prompted the initiation of treatment, predominantly employing a combination of isoniazid, rifampicin, and ethambutol in four patients, and isoniazid and rifampicin in the fifth. Treatment duration ranged from six to nine months. One-year follow-up indicated a favourable outcome for all patients.

Conclusions: This study shows that ofloxacin prophylaxis may in some cases fail to prevent iatrogenic BCGitis.

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简介：卡介苗疗法是治疗未浸润平滑肌的膀胱肿瘤的标准疗法：卡介苗疗法是治疗未浸润平滑肌的膀胱肿瘤的标准疗法。建议使用氟喹诺酮类抗生素进行预防，以降低卡介苗感染（卡介苗炎）累及呼吸道的风险：本研究描述了五例卡介苗炎病例，患者均为男性，中位年龄为 71 岁[范围：66-77 岁]，在卡介苗治疗非侵袭性膀胱肿瘤（pT1a 级）期间接受了氧氟沙星预防治疗。这些患者中有四人在最后一次注射后八小时内出现发热以及呼吸困难和咳嗽等呼吸道症状。其中三人在一个月内体重大幅下降。胸部扫描结果一致显示为粟粒状。虽然只有一名患者的卡介苗鉴定得到证实，但典型的临床和 CT 表现促使患者开始接受治疗，其中四名患者主要采用异烟肼、利福平和乙胺丁醇联合治疗，第五名患者采用异烟肼和利福平联合治疗。治疗时间从 6 个月到 9 个月不等。一年的随访结果显示，所有患者的疗效都很好：这项研究表明，氧氟沙星预防性治疗在某些情况下可能无法预防先天性卡介苗炎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue des maladies respiratoires 医学-呼吸系统

CiteScore

1.10

自引率

16.70%

发文量

168

审稿时长

4-8 weeks

期刊介绍： La Revue des Maladies Respiratoires est l''organe officiel d''expression scientifique de la Société de Pneumologie de Langue Française (SPLF). Il s''agit d''un média professionnel francophone, à vocation internationale et accessible ici. La Revue des Maladies Respiratoires est un outil de formation professionnelle post-universitaire pour l''ensemble de la communauté pneumologique francophone. Elle publie sur son site différentes variétés d''articles scientifiques concernant la Pneumologie : - Editoriaux, - Articles originaux, - Revues générales, - Articles de synthèses, - Recommandations d''experts et textes de consensus, - Séries thématiques, - Cas cliniques, - Articles « images et diagnostics », - Fiches techniques, - Lettres à la rédaction.