Post-Vaccination disseminated BCG infection in an 8-month-old infant

Abstract

Background: Disseminated bacilli calmette-Guerin (BCG) infection after inoculation with live vaccine is considered to result from impaired immunity of the child. However, half of the cases are regarded as idiopathic because no well-defined immunodeficiency condition can account for the infection. Case report: An 8-month-old male infant was admitted with an ulcer on his left arm at the site of a BCG inoculation received five mounths previously. He also had a fever, productive cough and respiratory distress for two weeks prior to admission and the patient received a broad–spectrum antibiotic without any response. A clinical examination revealed a 33 cm mass in the upper, left quadrant of the patient’s chest. A chest X-ray showed widespread reticulation and corrosion on the seventh rib. The patient died from cardiopulmonary arrest 12 days post admission. In the antopsy of the patient, samples taken from several organs of he body showed a collection of acid–fast bacilli and a spread of tuberculoid infection (BCGosis). Conclusions: Although the BCG vaccine has been in use since 1921 and its protective effect for disseminated, meningial and pulmonary tuberculosis is clear, controversy continues around its use. The most serious complication of BCG vaccine is a disseminated BCG infection that may lead to death.