Complications of bacille Calmette-Guérin (BCG) vaccination and immunotherapy and their management.
Complications of bacille Calmette-Guérin (BCG) vaccination and immunotherapy and their management.
复制标题
卡介苗 (BCG) 疫苗接种和免疫治疗的并发症及其管理。
DOI：
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
Grange Jm
中科院分区：
文献类型：
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作者：
Grange Jm
卡介苗接种后的并发症并不常见。接种疫苗的人中只有不到千分之一会出现严重的局部反应，而发生严重传播性疾病的人不到百万分之一。局部并发症，包括过敏反应、注射部位脓肿和局部淋巴结病，通常是自限性的。它们通常是由于技术错误造成的，包括意外地皮内注射了更强的经皮疫苗，或接种对象选择不当。注射部位的脓肿通常对引流和异烟肼或红霉素化疗有反应。淋巴结病对抗菌治疗反应较差，可能需要手术化脓或排出病变，以加速恢复和给予良好的美容效果。播散性疾病通常发生在免疫力受损的人群中，通常是致命的。永远不应该给已知感染艾滋病毒的人接种卡介苗，但是感染艾滋病毒的母亲所生的孩子出现并发症的风险很低。膀胱内灌注卡介苗治疗膀胱癌也可导致播散性疾病，但这对抗结核化疗有反应。
Complications of bacille Calmette-Guérin (BCG) vaccination are uncommon. Fewer than one in 1000 people vaccinated develop significant local reactions, and serious disseminated disease develops in fewer than one in a million. Localised complications--which include hypersensitivity reactions, abscesses at the injection site, and localised lymphadenopathy--are usually self limiting. They usually result from faulty technique, including the accidental intracutaneous injection of the stronger percutaneous vaccine, or poor selection of subjects for vaccination. Abscesses at the injection site usually respond to drainage and chemotherapy with isoniazid or erythromycin. Lymphadenopathy responds poorly to antimicrobial treatment and surgery may be needed for suppurating or discharging lesions to hasten recovery and give a good cosmetic result. Disseminated disease usually occurs in people with impaired immunity, in whom it is often fatal. BCG should never be given to people who are known to be infected with HIV, but the risk of complications in children born to HIV infected mothers is low. Disseminated disease can also result from intravesical instillation of BCG to treat bladder cancer, but this responds to antituberculosis chemotherapy.