Inadvertent intramuscular administration of high dose bacillus Calmette Guerin vaccine in a pre-term infant

Abstract

This case report examined the natural course of reaction after accidental intramuscular administration of high dose Bacille Calmette-Guιrin (BCG) vaccine into the anterolateral aspect of thigh of a pre-term infant as a part of routine vaccination instead of intra-dermal injection into the arm. There is no consensus on the best management of this complication, although in this case healing was prolonged but was spontaneous without anti-tubercular chemotherapy.

The Outcome of Accidental Bacille Calmette-Guérin Overdose During Routine Neonatal Immunization

“…In 2009, a 14-year-old had surgical excision of an 8-mm fluctuant lump and rifampicin and isoniazid for 6 weeks after receiving 10-fold (1 mL instead of 0.1 mL) the recommended dose of BCG-Connaught vaccine. 5 In 2 of the 6 reports, 2,4 no treatment was given. Treatment was given after suppurative lymphadenitis occurred in 1, 6 and prophylaxis was offered in 2 reports.…”

“…1 In all recent reports of predominantly neonatal overdose, adverse events were limited to mild adverse reactions such as abscess or lymphadenitis in small numbers. 1–6 Possible reasons for BCG adverse reactions, in general, have been attributed to younger age, dosage, strain type, and administrative technique. The Glaxo 1077, Tokyo 172-1, or Moreau RDJ strains are known to be less reactogenic than the Pasteur 1173 P2 and Danish 1331 strains, which cause more adverse reactions.…”

Dual Bacillus Calmette–Guerin vaccination along the border communities of Angola and Namibia

“…[2] The occurrence of this case of dual BCG vaccination also raises concern on the magnitude of such cases and the sensitivity of the surveillance for AEFI. Hence, the two countries need to strengthen the surveillance AEFI through mobilization of communities, training of focal health workers, supervision, and monitoring by the district and provincial teams, to identify such cases and implement necessary remedial actions.…”

“…In other to strengthen the performance of immunization system and other health-related issues along their borders, a memorandum of understanding was signed on March 18, 2011. [1] Although cases of overdose and or intramuscular instead intradermal injection have been well documented,[2] however, no published case of a child receiving two separate doses of Bacillus Calmette–Guerin (BCG) vaccine within the first 4 days of life as in the present report. Against this context, we present a case of double BCG vaccination of a child living in Calai town, Cuando Cubango province of Angola.…”

Disseminated Bacillus Calmette-Guérin (BCG) Infection Caused By Inadvertent Intravenous Infusion of BCG for the Treatment of Bladder Cancer: Case Report

“…Severe and prolonged local and systemic reactions occurred in both cases and were treated successfully with anti-tuberculosis drugs. [6][7][8] There is also a case report, published by Gul et al involving inadvertent intravenous administration in a 39-year-old male with high-grade transitional cell carcinoma. Following intravenous administration, the patient developed systemic symptoms including high fever, shivers and nausea along with multi-organ failure.…”