Too much of a good thing: Management of BCG vaccine overdose

Abstract

A 14-year-old girl was inadvertently immunised with an excessively large dose of BCG-Connaught vaccine (1.0 ml instead of 0.1 ml). Examination of the patient a few hours later revealed a subcutaneous fluctuant tender lump at the injection site. This was surgically excised within 12 h of immunisation and she was treated with isoniazid and rifampicin for six weeks. The patient developed no complications, other than a minor surgical scar. This case highlights the importance of the correct administration and dosing of BCG vaccine and suggests a management option that may prevent the severe local and systemic complications that are frequently associated with BCG overdose.