Bacillus Calmette-Guérin (BCG) is a live bacterial vaccine of Mycobacterium bovis to prevent tuberculosis (TB). It is given at birth or as early as possible according to the national immunization schedule. Usually, BCG is well tolerated. Severe adverse events following BCG vaccinations include local abscess, ulceration, and suppurative abscess. Disseminated BCGosis is the most devastating adverse event with a high fatality rate. It is seen most commonly in infants with primary immunodeficiencies or infants born with human immunodeficiency virus (HIV) infection. Here we present a 7-month female child who presented initially with BCG adenitis and was later diagnosed with disseminated mycobacterial infection; hence investigated, and the diagnosis was confirmed as severe combined immunodeficiency (SCID).
Norouzi S, Aghamohammadi A, Mamishi S, et al. Bacillus Calmette-Guérin (BCG) complications associated with primary immunodeficiency diseases. J Infect 2012;64(6):543–554. DOI: 10.1016/j.jinf.2012.03.012
Govindarajan KK, Chai FY. BCG adenitis-need for increased awareness. Malays J Med Sci 2011;18(2):66–69. https://pubmed.ncbi.nlm.nih.gov/22135589
Shahmohammadi S, Saffar MJ, Rezai MS. BCG-osis after BCG vaccination in immunocompromised children: case series and review. J Pediatr Rev 2014;2(1):47–54. DOI: 10.7508/JPR-V2-N1-62-74
Ong RYL, Chan SWB, Chew SJ, et al. Disseminated Bacillus-Calmette-Guérin infections and primary immunodeficiency disorders in Singapore: a single center 15-year retrospective review. Int J Infect Dis 2020;97:117–125. DOI: 10.1016/j.ijid.2020.05.117
Bhattad S. Mendelian susceptibility to Mycobacterial disease: a clinical and laboratory approach. Pediatr Inf Dis 2019;1(1):34–36. DOI: 10.5005/jp-journals-10081-1108