A boy born to a mother with unknown HIV infection was immunized with BCG in his first month of life. Seven months later axillary adenopathy developed. At the age of 10 months, 2 months after HIV infection had been diagnosed, papular skin lesions appeared all over his body. Mycobacterium bovis, BCG strain, was cultured from a lymph node and blood. Ziehl-Neelsen stain of a skin biopsy specimen showed histiocytes loaded with numerous acid-fast bacilli. The patient died 10 days later, before the infection was confirmed. This is the first reported case of disseminated BCG infection in an HIV-infected child presenting with cutaneous lesions.
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