Disseminated BCG Infection in Severe Combined Immunodeficiency

Yu, Rie; Satoh, Takahiro; Wakabayashi, Tomoe; Ueda, Nobuhiko; Yokozeki, Hiroo

doi:10.2340/00015555-1180

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…The published cases of BCG‐related tuberculosis developed a few cutaneous lesions on trunk and extremities. However, our case developed widespread numerous cutaneous lesions involving scalp, trunk, and limbs, which were pretty rare clinical manifestations . Besides, we found the patient had mutations in POLE gene.…”

Section: Discussionmentioning

confidence: 64%

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Disseminated tuberculosis cutis in an 8‐month‐old child associated with bacillus Calmette‐Guerin

Shen

Liu

2019

Int J Dermatology

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Section: Discussionmentioning

confidence: 64%

“…Skin lesions occasionally present as an initial manifestation in a disseminated BCG infection . In addition, any vaccinated infant with a persistent fever should be suspected of disseminated BCG infection …”

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis cutis in an 8‐month‐old child associated with bacillus Calmette‐Guerin

Shen

Liu

2019

Int J Dermatology

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“…There are currently no guidelines for treatment of post-HSCT BCG disease, and diverse regimens have been used [ 3 , 18 – 21 , 24 – 28 , 31 , 33 , 35 , 39 , 48 , 49 ]. Treatment modalities other than anti-microbials include steroids [ 27 , 29 , 44 , 47 , 48 ], surgical treatment, [ 19 , 20 , 23 , 27 , 48 ] IFNγ, [ 18 ] and anti-IL1 and anti-IL-6R antagonists [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Bacillus Calmette–Guerin (BCG) Vaccine-associated Complications in Immunodeficient Patients Following Stem Cell Transplantation

et al. 2020

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Purpose Bacillus Calmette–Guerin (BCG) is a live attenuated vaccine with the potential of causing severe iatrogenic complications in patients with primary immunodeficiency diseases (PID) before and after hematopoietic stem cell transplantation (HSCT). We aim to investigate risk factors of post-HSCT BCG-related complications in PID patients. Methods A retrospective analysis of pediatric PID patients who had received the BCG vaccine and underwent HSCT at Hadassah-Hebrew University Medical Center, between 2007 and 2019. Results We found 15/36 (41.67%) patients who developed post-HSCT BCG-related complications. The most significant risk factor for developing BCG-related complications was T cell deficiency (47.6% of the non-complicated vs 83.3% of the BCGitis and 100% of the BCGosis groups had T cell lymphopenia, p = 0.013). None of the chronic granulomatous patients developed BCG-related manifestation post-transplant. Among T cell–deficient patients, lower NK (127 vs 698 cells/μl, p = 0.04) cell counts and NK-SCID were risk factors for ongoing post-HSCT BCGosis, as was pretransplant disseminated BCGosis (33.3% of patients with BCGosis vs none of the non-BCGosis patients, p = 0.04). Immune reconstitution inflammatory syndrome (IRIS) was observed in 3/5 patients with Omenn syndrome. Prophylactic antimycobacterial treatment was not proven effective. Conclusion BCG vaccination can cause significant morbidity and mortality in the post-transplant T cell–deficient patient, especially in the presence of pre-transplant disease. Taking a detailed medical history prior to administering, the BCG vaccine is crucial for prevention of this complication.

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Mycobacterial Infections

Yates,

Walker

2016

Rook's Textbook of Dermatology, Ninth Edition

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Infections of the skin caused by mycobacteria have a wide geographical distribution. The clinical manifestations are varied and not necessarily species‐specific. Mycobacterium tuberculosis infection of the skin is often a chronic infection but may present as immunological phenomena – tuberculids. An increasing number of species are recognized as causing non‐tuberculous mycobacterial infections. Immunosuppression appears to increase the risk of some mycobacterial infections and the role of HIV and iatrogenic immune modulation are notable risk factors. Molecular diagnostics have increased the ability to identify specific organisms but prolonged antimicrobial therapy is often required.

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Disseminated BCG Infection in Severe Combined Immunodeficiency

Cited by 6 publications

References 9 publications

Disseminated tuberculosis cutis in an 8‐month‐old child associated with bacillus Calmette‐Guerin

Disseminated tuberculosis cutis in an 8‐month‐old child associated with bacillus Calmette‐Guerin

Bacillus Calmette–Guerin (BCG) Vaccine-associated Complications in Immunodeficient Patients Following Stem Cell Transplantation

Mycobacterial Infections

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