Disseminated BCG Infection (BCGosis) After BCG Vaccination

M Chitlangia,P Poudel

doi:10.3126/jnps.v34i1.9679

M Chitlangia, P Poudel

Open Access

https://doi.org/10.3126/jnps.v34i1.9679

Copy DOI

Abstract

BCG vaccine has excellent safety profile. Disseminated BCG infection, so called BCGosis and death have occurred in few cases, mainly in those with impaired immunity. We are reporting a seven month old infant who developed BCGosis after BCG vaccination. She presented with weight loss, fever, axillary lymphadenopathy and hepato-splenomegaly. She did not respond to standard antitubercular treatment. In the context of increasing number of reported cases of BCGois in HIV era, inoculation of BCG might be postponed in a suspected case of immune-deficiency disease, until it is ruled out. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9679 J Nepal Paediatr Soc 2014;34(1):62-64

Highlights

BCG (Bacilli Calme e–Guérin) vaccine is administered worldwide to prevent severe forms of tuberculosis and is recommended for rou ne use at birth in countries with high tuberculosis prevalence
Disseminated BCG infec on, so called BCGosis and death have occurred in 1 to 20 cases per 10 million doses administered, this problem is restricted to persons with impaired immunity, such as children with severe combined immunodeficiency disease (SCID), chronic granulomatous disease (CGD) or with human immunodeficiency virus (HIV) infec on[2,3,4,5,6,7]
We are repor ng an infant admi ed to BP Koirala Ins tute of Health Sciences, Dharan, Nepal, who had systemic BCG infec on (BCGosis) a er BCG vaccina on

Summary

Introduction

BCG (Bacilli Calme e–Guérin) vaccine is administered worldwide to prevent severe forms of tuberculosis and is recommended for rou ne use at birth in countries with high tuberculosis prevalence. It has an excellent safety profile with rare serious complica ons[1]. A so to firm, mobile right axillary lymph node (4x4 cm in size) was present which was discharging scanty amount of pus. Because of economic constraints and progressive deteriora on in general condi on despite treatment, parents denied further inves ga on and child was discharged home on ATT. There was no opportunity to evaluate the pa ent for primary immunodeficiency diseases

Discussion

Findings

Conclusion