Treating BCG-induced disease in children

Abstract

Treating BCG-induced disease in children.

Local Cutaneous Complications After Bacille Calmette-Guerin Vaccine: Experience of a Single Center

“…Cuello-Garcia et al found isoniazid injection after aspiration may be useful, but there are limited data in literature [5]. In our study, oral isoniazid and rifampicin treatments were given to six (30%) patients.…”

“…Several complications have been reported after the routine immunization program of BCG vaccine. Although some of these are normal vaccine reactions, unexpected complications have been noted [3][4][5][6][7][8][9]. Adverse reactions may be affected with some factors like patient's age, vaccine strains, dosage, erroneous administration, and disturbance of cellular immunity [11].…”

“…In literature anti-tuberculosis drugs are not recommended for routine treatment of local complications. Low penetration of anti-tuberculosis drugs into the abscess cavity and pyrazinamide resistance of M. bovis strains are some problems [5,21]. Early drainage is recommended for abscess formation and suppurative lymphadenitis [5].…”

“…These lesions heal with scar in approximately 3 months. Although BCG vaccine complications are so rare, in literature erythema, soreness, abscess formation, purulent drainage, ulcer, keloid scar, blistering, regional lymphadenopathy, disseminated BCG-itis, osteomyelitis and osteitis have been reported in some cases [3][4][5][6][7][8][9]. There is no consensus on the treatment of local complications of BCG vaccine.…”

Successful management of cutaneous BCG dissemination in a child affected by SCID and receiving allogeneic hematopoietic stem cell transplant

“…[4][5][6][7][8] Our patient affected with T-B+ SCID presented a localized infection at the site of inoculum and satellite lymph node, a consequence of BCG infection that became disseminated during pre-engraftment bone marrow aplasia induced by allo-HSCT conditioning regimen, despite 4 months of previous, presumptively effective anti-BCG therapy with isoniazid, rifampin and ethambutol. [9][10][11] This dissemination was finally controlled by this combination of antibiotics, with temporary addition of amikacin (3 months) and levofloxacin (6 months) 11,12 in the early postengraftment period, and immune reconstitution (despite immunosuppression for management of GvHD). A comprehensive Medline search using the keywords 'cutaneous complication' and 'BCG vaccination', without any other filter, showed that skin manifestations like subcutaneous nodules, rash, ulcers and erythema in SCID patients with disseminated BCG have been described.…”