Local Cutaneous Complications After Bacille Calmette-Guerin Vaccine: Experience of a Single Center

Abstract

Background: Bacille Calmette-Guerin (BCG) vaccine may cause some cutaneous complications at the injection site. Although some of these are normal reactions, unexpected complications may be seen. Clinical features, treatment modalities and outcomes of these complications have not been clearly defined in literature. We aimed to determine the local cutaneous complications after BCG vaccine and clinical experiences in our hospital. Methods: Between May 2013 and December 2016, previously healthy children aged older than 2 months, without underlying disease or drug use history, who were admitted with localized cutaneous complications after BCG vaccine, were retrospectively analyzed. Demographic and clinical features, laboratory findings, treatments and outcomes were collected from database. Results: Twenty patients were diagnosed as having local cutaneous complications. Abscess formation (30%), localized inflammation signs (45%), purulent discharge (10%), crust (10%) and eczematous lesion (5%) were found as local cutaneous complications. Drainage was performed in 14 (70%) patients. Oral amoxicillin clavunate therapy was given to four (20%) patients due to isolating Staphylococcus aureus (2/4), Staphylococcus hominis (1/4), and Exiguobacterium aurantiacum (1/4) from the drainage or purulent discharge culture. Anti-tuberculosis drugs (isoniazid and rifampicin) were used in six (30%) patients. Five of them had positive acid-resistant bacilli, tuberculosis polymerase chain reaction or tuberculosis culture results and one (5%) patient was diagnosed as having a lupus vulgaris because histopathological examination of his lesion showed granulomatous dermatitis. In addition, there was no lesion to drain in four (20%) patients and they were followed without treatment. On follow-up, all lesions completely recovered. Conclusions: There is no still consensus about treatment of the local complication after BCG vaccine. In our study, some complications improved with conservative treatment. However, drainage, anti-tuberculosis drugs and antibiotic treatments were needed in some cases. As a result, treatment should be decided to each patien t’s clinical symptoms and underlying disease. Int J Clin Pediatr. 2017;6(3-4):37-41 doi: https://doi.org/10.14740/ijcp279w