Disseminated Mycobacterial Infection and Scabies Infestation

Brondfield, Sam; Reid, Michael; Patel, Kiran; Ten, Rosa M.; Dhaliwal, Gurpreet

doi:10.1016/j.amjmed.2015.06.008

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Cristiane Nunes-Santos et al published a systematic review of BCG complications in patients with IEI with selected defects affecting either innate or adaptive immunity published after 2010 ( 21 ). BCGosis was reported in 4 (8%) out of 19 patients with a gain-of-function STAT1 (signal transducer and activator of transcription 1) mutation, impairment of IFN -γ responses immunity to mycobacterial infection, and in 1 out of 357 patients with GATA2 deficiency, a deficiency in hematopoietic transcription factor GATA2 ( 21 , 39 , 40 ). In a large group of our HIES (hyper-IgE syndrome) patients, reported by Nunes-Santos et al, no BCG complications were noted ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

BCG Moreau Polish Substrain Infections in Patients With Inborn Errors of Immunity: 40 Years of Experience in the Department of Immunology, Children's Memorial Health Institute, Warsaw

Bernatowska

Pac

Heropolitańska-Pliszka

et al. 2022

Front. Pediatr.

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ObjectiveWe aimed to assess BCG (Bacillus Calmette-Guérin) complications in patients with Inborn Errors of Immunity (IEI), according to the inherited disorders and associated immunological defects, as well as the different BCG substrains.MaterialWe studied adverse reactions to the locally-produced BCG Moreau vaccine, analyzed in patients with IEI diagnosed between 1980 and 2020 in the Department of Immunology, Children's Memorial Health Institute (CMHI), Warsaw. These results were compared with previously published studies.ResultsSignificantly fewer disseminated BCG infections (BCGosis) were found in 11 of 72 (15%) SCID (Severe Combined Immunodeficiency) NK (Natural Killer)-phenotype patients, when compared with the 119 out of 349 (34%) (p = 0.0012) patients with SCID with BCG in other countries. Significantly fewer deaths caused by BCGosis were observed (p = 0.0402). A significantly higher number of hematopoietic stem cell transplantations (HSCTs) were performed in the CMHI study (p = 0.00001). BCGosis was found in six patients with Mendelian susceptibility to mycobacterial diseases (MSMD). Other patients with IEI prone to BCG complications, such as CGD (Chronic Granulomatous Disease), showed no case of BCGosis.ConclusionThe BCG Moreau substrain vaccine, produced in Poland since 1955, showed genetic differences with its parental Brazilian substrain together with a superior clinical safety profile in comparison with the other BCG substrains, with no BCGosis in patients with IEI other than SCID and MSMD. Our data also confirmed significantly fewer cases of BCGosis and deaths caused by BCG infection in patients with SCID with this vaccine substrain. Finally, they confirmed the protecting role of NK cells, probably via their production of IFN-γ.

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Section: Discussionmentioning

confidence: 99%

BCG Moreau Polish Substrain Infections in Patients With Inborn Errors of Immunity: 40 Years of Experience in the Department of Immunology, Children's Memorial Health Institute, Warsaw

Bernatowska

Pac

Heropolitańska-Pliszka

et al. 2022

Front. Pediatr.

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“…11 Additionally, there is a reported case of a disseminated NTM infection with M. kansasii and scabies in a 21-year-old male who was found to have GATA2 deficiency. 12 Although not clearly defined, a defect in cell-mediated immunity may play a role in susceptibility to both atypical mycobacteria infections and infestations with S. scabiei. We report a case of concomitant M. haemophilum and Sarcoptes scabiei infestation, and encourage readers to include both diseases in the differential diagnosis of immunocompromised patients presenting with generalized symptomalogy with lesions of different morphologies.…”

Section: Introductionmentioning

confidence: 99%

Disseminated Cutaneous Mycobacterium Haemophilum Infection and Concomitant Crusted Scabies in an Iatrogenically Immunocompromised Patient - A Case Report

et al. 2018

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Mycobacterium haemophilum and crusted scabies are rare cutaneous diseases reported in distinct immunocompromised hosts. M. haemophilum is a skin and soft tissue infection, whereas crusted scabies is an infestation of the skin. Whereas scabies infestation is readily diagnosed, M. haemophilum infection poses a diagnostic challenge due to its rarity as well as varied clinical and histologic presentations. Although both scabies infestation and M. haemophilum have been reported in the literature separately, to our knowledge no previous reports have described these diseases occurring simultaneously in an iatrogenically immunosuppressed patient. We report herein a rare case of concomitant M. haemophilum and scabies infestation in a 38-year-old woman with dermatomyositis on multiple immunosuppressive agents.

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Bacille Calmette–Guerin Complications in Newly Described Primary Immunodeficiency Diseases: 2010–2017

Nunes-Santos

Rosenzweig

2018

Front. Immunol.

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Bacille Calmette–Guerin (BCG) vaccine is widely used as a prevention strategy against tuberculosis. BCG is a live vaccine, usually given early in life in most countries. While safe to most recipients, it poses a risk to immunocompromised patients. Several primary immunodeficiency diseases (PIDD) have been classically associated with complications related to BCG vaccine. However, a number of new inborn errors of immunity have been described lately in which little is known about adverse reactions following BCG vaccination. The aim of this review is to summarize the existing data on BCG-related complications in patients diagnosed with PIDD described since 2010. When BCG vaccination status or complications were not specifically addressed in those manuscripts, we directly contacted the corresponding authors for further clarification. We also analyzed data on other mycobacterial infections in these patients. Based on our analysis, around 8% of patients with gain-of-function mutations in STAT1 had mycobacterial infections, including localized complications in 3 and disseminated disease in 4 out of 19 BCG-vaccinated patients. Localized BCG reactions were also frequent in activated PI3Kδ syndrome type 1 (3/10) and type 2 (2/18) vaccinated children. Also, of note, no BCG-related complications have been described in either CTLA4 or LRBA protein-deficient patients; and not enough information on BCG-vaccinated NFKB1 or NFKB2-deficient patients was available to drive any conclusions about these diseases. Despite the high prevalence of environmental mycobacterial infections in GATA2-deficient patients, only one case of BCG reaction has been reported in a patient who developed disseminated disease. In conclusion, BCG complications could be expected in some particular, recently described PIDD and it remains a preventable risk factor for pediatric PIDD patients.

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Disseminated Mycobacterial Infection and Scabies Infestation

Cited by 3 publications

References 5 publications

BCG Moreau Polish Substrain Infections in Patients With Inborn Errors of Immunity: 40 Years of Experience in the Department of Immunology, Children's Memorial Health Institute, Warsaw

BCG Moreau Polish Substrain Infections in Patients With Inborn Errors of Immunity: 40 Years of Experience in the Department of Immunology, Children's Memorial Health Institute, Warsaw

Disseminated Cutaneous Mycobacterium Haemophilum Infection and Concomitant Crusted Scabies in an Iatrogenically Immunocompromised Patient - A Case Report

Bacille Calmette–Guerin Complications in Newly Described Primary Immunodeficiency Diseases: 2010–2017

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