BCG Vaccine Induced Tuberculous Osteomyelitis of Left Distal Femur in a Young Child: Case Report and Literature Review

Abstract

Tuberculosis (TB) is an essential problem for healthcare systems especially in developing countries. TB continues to pose a significant global health burden [1]. Bacillus Calmette-Guérin (BCG) is an important vaccine used to prevent Tuberculosis (TB), especially meningeal TB and disseminated TB disease in children [2]. BCG is prepared from live bovine tuberculosis bacillus, and is given to protect against TB. Although vaccination against TB by means of BCG is widespread all over the world and is generally considered to be safe, but serious adverse reactions can occur. These may be minor such as abscess formation or skin ulceration at the site of vaccination to major adverse reaction such as fatal disseminated infection especially in patients with immune deficiency [3]. These adverse reactions after BCG vaccination depend on the BCG dose, vaccine strain, vaccine administration method, injection technique, and recipient’s underlying immune status [4]. The aim of this case report is to point out that clinical suspicion of BCG-induced osteomyelitis is warranted in pediatric patients with chronic symptoms of pain, limping, swelling and a limited ROM in the extremity. We also aimed to remind that imaging and culture studies may guide the clinician although tissue biopsies and genetic tests can confirm the histopathology and to review related articles.