Abstract

We report an infant case of Mycobacterium Bovis Osteomyelitis of the proximal side of the humerus as a complication of BCG Vaccination.BCG vaccination was performed at the age of 5 months. One year and 8 months after vaccination, he presented left shoulder pain. Pyogenic osteomyelitis of the humerus was suspected.After 6 weeks of antibioticotherapy, he showed no response and he was moved to our hospital. At admission, he had a pneumonia complication, and PPD test results were strongly positive. We performed an open biopsy, with curettage of the involved bone. Microscopic examination revealed caseous necrosis in the tissue, and Mycobacterium was isolated in the culture. Genetic analysis of the DNA by a multiplex polymerase chain reaction method detected Mycobacterium bovis, Tokyo strain, the same strain used for vaccination. We started a regimen consisting of rifampicin and isoniazid. Compared with other countries, complications due to BCG vaccination in Japan are relatively rare. We found a total of 11 reports of BCG osteomyelitis in Japan, including this case. It is necessary to consider the possibility of diseases such as lymphadenitis or osteomyelitis after BCG vaccination in infants.

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