病例报告

卡介苗膀胱灌注治疗致结核性前列腺脓肿1例

  • 叶海云 ,
  • 许清泉 ,
  • 黄晓波 ,
  • 马凯 ,
  • 王晓峰
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  • (北京大学人民医院泌尿外科,北京100044)

网络出版日期: 2015-12-18

Tuberculous prostatic abscess following intravesical bacillus Calmette-Guérin immunotherapy: a case report

  • YE Hai-yun ,
  • XU Qing-quan ,
  • HUANG Xiao-bo ,
  • MA Kai ,
  • WANG Xiao-feng
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  • (Department of Urology, Peking University People’s Hospital, Beijing 100044, China)

Online published: 2015-12-18

摘要

Morales等[1]于1976年报道应用卡介苗(bacillus Calmette-Guérin,BCG)治疗膀胱癌。目前BCG膀胱灌注是治疗非肌层浸润性膀胱癌的常用方法,但该治疗方法可引起一系列的并发症,包括结核性前列腺炎。BCG致结核性前列腺炎发展为前列腺脓肿罕见,国内外仅有少数个案报道,现将北京大学人民医院近期收治的1例卡介苗膀胱灌注治疗致前列腺脓肿的病例报告如下。

本文引用格式

叶海云 , 许清泉 , 黄晓波 , 马凯 , 王晓峰 . 卡介苗膀胱灌注治疗致结核性前列腺脓肿1例[J]. 北京大学学报(医学版), 2015 , 47(6) : 1039 -1041 . DOI: 10.3969/j.issn.1671-167X.2015.06.029

Abstract

Intravesical bacillus Calmette-Guérin (BCG) was a common treatment for non-muscle invasive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor (TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound (TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Because of the good response to the medicine, no further aspiration or drainage of prostatic abscess was carried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

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