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Journal of Tropical Pediatrics Advance Access published online on July 1, 2008
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmn053
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Disseminated Bacillus Calmette–Guerin Infection after BCG Vaccination

Mohammad Sadegh Rezaia, Ghamartaj Khotaeia, Setareh Mamishia,b, Maryam Kheirkhaha and Nima Parvaneha,b

aDepartment of Pediatrics, School of Medicine, Medical Sciences/University of Tehran
bInfectious Disease Research Center, Medical Sciences/University of Tehran

Correspondence: Setareh Mamishi, No. 62, Dr Gharib St., Infectious Disease Department, Children Medical Center Hospital, Tehran, Iran. Tel.: +98 21 66428996; Fax: +98 21 66428996; E-mail <smamishi{at}sina.tums.ac.ir>.


  Abstract

The BCG is administered to all the newborns at birth in Iran. Systemic adverse reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection are rare. This is a retrospective study of 15 cases <72 months who were admitted with systemic syndrome compatible with disseminated mycobacterial disease during 2004–07. Disseminated BCG disease occurred in eight children younger than 6-months old and 12 patient younger than 12-months old. Twelve patients were male. Nine of 15 patients had well known primary immune deficiency disorders including severe combined immunodeficiency, chronic granulomatous disease; cell mediated immune defect and HIV infection. Nine (60%) cases had good response to four anti-mycobacterial drug therapy and interferon gamma. Disseminated BCG disease is a rare but devastating complication of BCG vaccination that should be considered in the appropriate clinical setting. Severe immune-compromised infants are at greatest risk and they respond poorly to standard therapies.

Key Words: BCG • immunodeficiency • vaccination


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