RESUMO
We report a case of sepsis from Mycobacterium bovis Bacillus Calmette-Guérin (BCG) with low-level isoniazid resistance following intravesical treatment for bladder cancer. Isoniazid resistance in BCG has therapeutic implications when it causes infections after intravesical instillation. For these circumstances, we propose some modifications to existing treatment guidelines for BCG infection.
Assuntos
Bacteriemia/diagnóstico , Terapia Biológica/efeitos adversos , Farmacorresistência Bacteriana , Imunoterapia/efeitos adversos , Isoniazida/farmacologia , Mycobacterium bovis/efeitos dos fármacos , Neoplasias da Bexiga Urinária/terapia , Administração Intravesical , Idoso , Antituberculosos/farmacologia , Bacteriemia/microbiologia , Terapia Biológica/métodos , Humanos , Imunoterapia/métodos , Masculino , Mycobacterium bovis/imunologiaRESUMO
Severe arterial hypertension rarely occurs in the neonatal period but may have life-threatening consequences. It is most often caused by renal parenchymal or vascular abnormality, which, to be accurately diagnosed, may require a combination of imaging modalities. We report on a case of neonatal hypertension presenting as cardiac failure. Initial imaging suggested unilateral renal artery stenosis, but this was not corroborated by magnetic resonance angiography. Surgical nephrectomy was curative for the hypertension and also allowed diagnosis of renal tubular dysgenesis. Unilateral congenital tubular dysgenesis without renal infarction has not been previously reported. We speculate that the condition was secondary to a period of localised hypoperfusion during early foetal life.