Abstract
Vaccination with bacille Calmette-Guerin (BCG) has been used for the prevention of tuberculosis in many areas of the world. It is estimated that more than three billion people worldwide have been vaccinated with live BCG since 19459. In almost all children, inoculation with BCG is harmless. However, it must be understood that BCG, like other vaccines, such as that for poliomyelitis and even that for measles, mumps, and rubella, occasionally produces adverse reactions5,11,21-23. Despite these rare complications, BCG has proved to be effective for preventing miliary tuberculosis and tubercular meningitis in many developing countries. Disseminated complications were observed in association with approximately one per million vaccinations, and severe local reactions occurred in approximately 2 percent of individuals who were vaccinated11,22,23. BCG osteomyelitis has been reported often in Europe but relatively rarely elsewhere1-3,6,7,13,25; however, it may not be as rare as it seems. It is possible that the diagnosis may be missed unless the treating physician has a high index of suspicion and unless a sensitive technique of identification is available. This complication deserves greater attention because it has been reported in association with intravesical administration of BCG for the treatment of carcinoma of the bladder8,24. The reason why the importance of BCG osteomyelitis has often been neglected may be related to the difficulty of confirming the diagnosis. Traditionally, the definitive diagnosis is made on the basis of a positive identification of the BCG strain of Mycobacterium bovis on tissue culture, which is by no means simple22. However, the task has been made easier by advances in molecular biology and the application of molecular biological techniques to …
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More From: The Journal of bone and joint surgery. American volume
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