BCG-osis after BCG vaccination in immunocompromised children: Case series and review

Bacillus Calmette Guerin (BCG) developed by Albert Calmette and Camille Guerin in France between ۱۹۰۸ and ۱۹۲۱ contained a live attenuated strain of Mycobacterium bovis and was administered worldwide to prevent tuberculosis. BCG vaccination is also administered at birth to all the newborns in Iran. Disseminated BCG infection after BCG vaccination is rare. Here in, we report ۲ new cases of disseminated BCG infection and review ۱۵ additional cases identified from our previous retrospective study during a ۵-year period from ۲۰۰۵-۲۰۱۰. All of these reported patients were vaccinated. Impaired immunity was detected in ۱۰ cases (۵۹%) including severe combined immunodeficiency, chronic granulomatous disease, Mendelian susceptibility to mycobacterial disease, combined variable immunodeficiency, and HIV infection. Response to therapy was poor among those patients with immune deficiencies, but the overall mortality rate was ۳۲.۳%. Disseminated BCG infection is a rare but devastating complication of vaccination. Immune-compromised children are at high risk of developing BCG related complications including regional BCG-itis or disseminated disease BCG-osis.

Keywords:

BCG-osis , Disseminated BCG infection , Immunodeficiency , Mendelian susceptibility to mycobacterial disease , Children