卡介苗-谷氨酰胺膀胱内治疗尿路上皮癌后髂总动脉牛分枝杆菌相关性动脉瘤

IF 0.1 Q4 UROLOGY & NEPHROLOGY
D. Voci, N. Kucher, A. Zimmermann, S. Barco
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引用次数: 0

摘要

一例54岁男性非侵袭性尿路上皮癌(T1N0M0)在接受辅助卡介苗(BCG)灌注治疗2年后,计划经尿道切除。在此期间,患者接受了抗生素治疗(利福平、异烟肼、乙胺丁醇),以治疗疑似牛分枝杆菌全身感染,伴有B型症状和淋巴结病。病人的痰中培养出牛分枝杆菌卡介苗。术前CT显示左侧髂总动脉动脉瘤,直径约3.5 cm(图1),右侧髂总动脉夹层(图2)。这些发现在8个月前的CT扫描中未见记录。临床和影像学表现与bcg相关的真菌性动脉瘤一致。诊断后2天通过中线剖腹行异种心包置换术,无并发症。对术中组织样本进行Ziehl-Neelson染色和聚合酶链反应(IS6110和M65方法)并确认诊断。患者可在手术后几天出院回家,并采用相同的术前抗生素治疗。在与domo的感染专家会诊后,建议患者继续抗生素治疗4个月。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mycobacterium bovis Associated Aneurysm of the Common Iliac Artery After Bacillus Calmette-Guérin Intravesical Treatment for Urothelial Carcinoma
A 54-year-old man with a non-invasive urothelial carcinoma (T1N0M0) was scheduled for transurethral resection after a 2-year treatment with adjuvant Bacillus CalmetteGuérin (BCG) instillation therapy. During this period, the patient received antibiotic therapy (Rifampicin, Isoniazid, Ethambutol) for a suspected Mycobacterium bovis systemic infection with B symptoms and lymphadenopathy. A culture of Mycobacterium bovis BCG grew from the sputum of the patient. The preoperative computed tomography (CT) showed an aneurysm of the left common iliac artery with a diameter of approximately 3.5 cm (Figure 1) and a dissection of the right common iliac artery (Figure 2). These findings had not been documented in a previous CT scan done 8 months before. The clinical and imaging findings were consistent with those of a BCG-associated mycotic aneurysm. A xenopericardial graft replacement via midline laparotomy was performed two days after diagnosis without complications. A Ziehl-Neelson staining procedure and a polymerase chain reaction (IS6110 and M65 methods) were performed on an intraoperative tissue sample and confirmed the diagnosis. The patient could be discharged home a few days after the procedure with the same established preoperative antibiotic therapy. After consultation with the infectiologists in the domo, the patient was recommended to continue the antibiotic therapy for another 4 months.
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来源期刊
Journal of Urological Surgery
Journal of Urological Surgery UROLOGY & NEPHROLOGY-
自引率
33.30%
发文量
42
审稿时长
16 weeks
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