Adverse reactions to Mycobacterium bovis bacille Calmette-Guerin vaccination against tuberculosis in Iranian children

PURPOSE: There are considerable variations in the number of adverse reaction reports related to vaccine from different countries. The aim of this study was to review the development of adverse reactions to bacille Calmette-Guerin (BCG) vaccination among hospitalized patients in an Iranian referral hospital. MATERIALS AND METHODS: We identified hospitalized patients with BCG complications in Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran during January 2007-April 2009. Data on demographics, clinical features, laboratory findings, personal history (including vaccination history), family history, and outcomes were retrieved from medical records. RESULTS: There were 46 cases with BCG complication during the 2 years period. All of the children received vaccination at birth. Twenty-eight patients (61%) were male. The mean age of the patients was 13.5 +/-11.3 months (range, 1 to 52 months; median, 10 months). The majority of children (57%) with BCG complication were less than 1 year old. Among hospitalized patients due to BCG complications, suppurative lymphadenitis was occurred in 28 children (61%) and lymphadenopathy was seen in 9 children (20%). Disseminated BCG was detected in 8 patients (17%) and only 1 child (2%) was presented with abscess. In 7% (n = 3) of children, the family history of BCG complications were positive. CONCLUSION: The most common side effect of the BCG vaccine in our study was suppurative lymphadenitis. Disseminated BCG infection in complications leading to hospitalization in our study was 17%. With regard to the difficulty in implementing such a guideline in settings where BCG is given to all newborns, registration of Iranian primary immunodeficiency disorders (PID) patients would be helpful to increase the awareness of medical community of Iran to investigate underlying disease. In addition, BCG vaccination should postpone in each newborn with a family history of PID until the definite condition has been ruled out.

Clinical features and laboratory findings of visceral leishmaniasis in children referred to children medical center hospital, Tehran, Iran during 2004-2011

Visceral leishmaniasis [VL] is one of the most important parasitic diseases endemic in northwestern and southern areas of Iran. The aim of the present study was to review the records of children hospitalized with VL in order to characterize the clinical features of children as well as laboratory finding in Children Medical Center Hospital, Tehran, Iran. The medical records of all children with a final diagnosis of VL were reviewed from 2004 to 2011. Demographic, clinical information, laboratory finding and treatment were considered. A total number of 34 children with confirmed VL through 2004-2011 were included in the study. The most prevalent sign and symptoms were fever [97.1%], pallor and weakness [97.1%], appetite loss [61.8%], splenomegaly [97.1%] and hepatomegaly [88.2%]. The most frequent laboratory abnormalities were hematological including anemia [97.1%], thrombocytopenia [91.2%] and leukopenia [67.6%]. Direct agglutination test [DAT] was performed in 23 cases and all of them showed anti-Leishmania antibodies with titers of >/= 1: 3200. In addition, 90% of patients had positive rK39 results. Identification of Ieishmania in the aspirates of the bone marrow was found in 83.3% of patients. Regional surveillance system in order to monitoring of leishmaniasis trends as well as detection of new emerging foci is recommended

[Identification of mycobacteria species in cutaneous lesions of sarcoidosis by PCR-restriction ragment length polymorphism [PCR-RFLP] method]

Sarcoidosis is a granulomatous multisystem disease of unknown etiology. It has recently been tired to detect Mycobacteria genome in biopsy specimens of patients with sarcoidosis by Polymorphism chain reaction method. To detect and identify Mycobacteria species in cutaneous lesions of the patients with sarcoidosis by PCR-RFLP. 20 patients with clinical diagnosis of sarcoidosis were enrolled in this study. Clinical manifestations, appearance of naked granuloma under light microscope and exclusion of other diagnoses confirmed the diagnosis of sarcoidosis in the patients. By PCR-RFLP, genome of Mycobacteria species was searched in paraffin embedded specimen of skin biopsies of the patients. Four PCR positive skin biopsy specimens of patients with cutaneous tuberculosis were used as positive control. 10 skin biopsy specimens with other than tuberculosis were used as negative control. Mycobacteria genome was not detected in any specimens of the patients. Our findings do not support the role of Mycobacteria species in the pathogenesis of sarcoidosis