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Revista Cubana de Pediatría
On-line version ISSN 1561-3119
Abstract
ABREU SUAREZ, Gladys; GONZALEZ VALDES, José Antonio; FUENTES FERNANDEZ, Gladys and PORTUONDO LEYVA, Reyna. Infection disseminated by the vaccine bacillus Calmette-Guerin. Rev Cubana Pediatr [online]. 2022, vol.94, n.2 Epub June 01, 2022. ISSN 1561-3119.
Introduction:
The infection disseminated by the vaccine bacillus Calmette-Guerin is a rare severe adverse reaction associated with immunodeficiency.
Objective:
Describe a series of five cases with disseminated vaccine infection.
Presentation of cases
: There are five cases vaccinated at birth: predominance of the male sex in 4 (80%), average age onset: 8.4 months in 2 (15 %) and age at diagnosis: 17.8 months in 6 (31 %); clinical picture of ulcerated vaccine footprint, ipsilateral axillary lymphadenitis and in distal regions, hepatosplenomegaly, involvement of other organs, with systemic and nutritional manifestations. There was consanguinity in three of the patients and suspicious family history of immunodeficiency in three others. All died: three were sick before the age of 3. Conventional immunological studies were performed in all cases. One patient had severe combined immunodeficiency, chronic granulomatous disease was suspected in one, and Mendelian susceptibility syndrome to mycobacteria in three.
Conclusions:
Although the BCG vaccine rarely presents dissemination of the vaccine bacillus, this entity should be suspected in young children, with the severe and systemic characteristics described, with manifestations suggestive to tuberculosis that do not respond to first-line anti-tuberculous treatment.
Keywords : disseminated BCG; disseminated infection by the vaccine bacillus Calmette-Guerin; BCGosis; adverse reactions to BCG.