Disseminated BCG Infection, Report of Three Cases

Simin Partovi,MD*, A. Bazrafshan ,MD**,Z.Badiei,MD***,N.Zabolinejad,MD****

Prof of Pediatric Gastroenterology*, Assistant Prof of Ped Surgery**,Ped Hematology***,Pathology****

Mashad University of Medical Sciences, Iran.

INTRODUCTION: BCG vaccination at birth is done routinely in Iran during last 40 years.Adverse reactions induced by BCG vaccination are very rare (0-23.8%).291 cases of osteitis had been reported from 13 countries during 26 years (1948-1974). Disseminated infections are even rarer and their estimated incidence is 0/1-4/3 per million vaccinated children.

MATERIALS & METHODS: Three cases of BCGitis were hospitalized with poor condition. All of them had lymphadenopathy (LAP) with fistula to the skin in the injection site,abdominal mass , peritoneal and small intestine involvement.

RESULTS : Fatal disseminated BCGitis is exceptional and affects specially the children with immune deficiency.

We report 3 cases of disseminated BCG infection leading to death in 2 cases. Two of them admitted with severe ascitis and multiple abdominal masses, they had got peritoneal and intestinal tuberculosis after BCG vaccination. The third one had hepatosplenomegaly, LAP and involvement of many organs including intestine and bones. All of them were immunedeficient.

CONCLUSION : Disseminated BCGitis is rarely seen after vaccination but is very dangerous and immunologic assessment often shows some defects.

Keywords: BCG, Immunedeficiency, GI tuberculosis, Vaccination