RESUMO
Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been widely used for the treatment of superficial transitional cell carcinoma of the bladder. We describe a rare case of supra-renal mycotic aortic aneurysm secondary to BCG instillation in a 75-year-old male. Patients presenting with systemic symptoms post-instillation, possibly with an aneurysm, should raise suspicion of BCG dissemination, which requires early instigation of anti-mycobacterial drugs.
Assuntos
Aneurisma Infectado/etiologia , Aneurisma da Aorta Abdominal/etiologia , Vacina BCG/efeitos adversos , Infecções por Mycobacterium/complicações , Administração Intravesical , Idoso , Aneurisma Infectado/microbiologia , Aneurisma Infectado/patologia , Aneurisma Infectado/cirurgia , Antibióticos Antituberculose/uso terapêutico , Aorta Abdominal/microbiologia , Aorta Abdominal/patologia , Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/microbiologia , Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Abdominal/cirurgia , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/microbiologia , Inglaterra , Etambutol/uso terapêutico , Evolução Fatal , Humanos , Isoniazida/uso terapêutico , Masculino , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium/cirurgia , Mycobacterium bovis/efeitos dos fármacos , Rifampina/uso terapêutico , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/microbiologiaRESUMO
Dantrolene sodium was effective in controlling spasticity and improving function in 11 of 13 patients taking part in a 14-week double-blind crossover study. Clonus and lower-extremity tendon jerks were reduced in almost all patients (10 and 11 respectively) during dantrolene sodium therapy at 200 to 400 mg/day. Activities of daily living showed marked improvement in 3 cases and moderate improvement in 8. All 13 patients reported decreases in the frequency of intermittent painful spasm. Side effects were minimal and consisted mainly of an initial 3- to 4-day period of weakness and lightheadedness.
