ABSTRACT
Objective To analyze the status of hepatitis B and BCG vaccination in children with special health status, and analyze the reasons for the delay of vaccination, so as to improve the timely vaccination rate. Methods A total of 1 129 children with special health status who were registered and vaccinated in our hospital from September 1, 2018 to January 23, 2020 were selected. All children were classified according to the major diseases based on the discharge records. The first injection time of hepatitis B and BCG vaccine was extracted, and the children were divided into different groups based on the number of people who delayed vaccination. The comparison between groups was performed by χ2 test. Results A total of 87 children without hepatitis B vaccination and 85 children without BCG vaccination were immediately vaccinated in our hospital after the establishment of the archives in our hospital. None of the 1 129 children with special health status had serious adverse reactions after vaccination. The most common diseases in the delayed hepatitis B vaccination children were premature infants, cardiovascular diseases, and nervous system diseases. The most common diseases in the delayed BCG vaccination children were premature infants, cardiovascular diseases, and neonatal disease. There was a significant difference between the number of delayed hepatitis B vaccination and the number of delayed BCG vaccination, with the number of delayed BCG vaccination being more (χ2=278.24, P<0.00). Conclusion Delayed vaccinations are common in children with special health status. Normal vaccination does not increase the incidence of adverse reactions in children with special health status. Medical staff’s understanding of diseases, types of diseases, and types of vaccines are important factors affecting the vaccination of children with special health conditions. Support from social environment, the understanding and cooperation from children's parents and guardians, and the understanding of medical workers on vaccines and diseases are the keys to truly improve the vaccination rate of children..
ABSTRACT
Bacillus Calmette-Guerin (BCG) is the live attenuated strain of Mycobacterium bovis that produces resistance to tuberculosis (TB) infection. BCG vaccination may induce various dermatologic complications. A 3-month-old infant who had BCG vaccination a month after birth developed erythematous papules and pustules on the trunk and both extremities. The biopsy from the left leg showed a granulomatous lesion. Acid fast staining and nested TB polymerase chain reaction (TB-PCR) were negative. A tuberculin skin test and an interferon-gamma release assay also revealed a negative result. A painful mass was noted on the left axillary area with a positive-nested TB-PCR and surgical excision was performed. The skin eruptions improved after 2 months of anti-tuberculosis medication. Herein, we report a case of disseminated papules and pustules with lymphadenitis after BCG vaccination.
Subject(s)
Humans , Infant , Bacillus , Biopsy , Extremities , Interferon-gamma Release Tests , Leg , Lymphadenitis , Mycobacterium bovis , Parturition , Polymerase Chain Reaction , Skin , Skin Tests , Tuberculin , Tuberculosis , VaccinationABSTRACT
The present study aimed to assess the CD4, CD8 and Gamma delta T cells blood levels for Curraleiro Pé-duro, as well as the specific IFN-γ response after BCG vaccination using flow cytometry. The specific immune response against BCG was also evaluated by tuberculin skin test, performed before and 45 days after the vaccination. For comparison purposes, the same parameters were investigated on Nellore calves, an exotic bovine with resistance previously demonstrated. Naturally, Curraleiro Pé-duro animals had greater levels of CD4, CD8 and Gamma delta lymphocytes (p<0.05). In response to vaccine, Curraleiro Pé-duro showed greater ability to respond specifically to BCG, generating resistance profile (Th1), evidenced by greater number of antigen specific CD4+ cells producing IFN-γ (p<0.05) and also higher tuberculin skin test reaction (p<0.05). Additionally, vaccinated Curraleiro Pé-duro calves had higher CD4 cells numbers than both Nellore control (p<0.05) and vaccinated groups (p<0.05). Curraleiro Pé-duro calves' higher basal lymphocytes blood level and stronger response in both IFN-γ and tuberculin skin test parameters probably play a positive role on protection/resistance to Mycobacterium bovis.
O presente estudo teve como objetivo avaliar níveis sanguíneos de células CD4, CD8 e células T gama-delta no sangue periférico de bezerros Curraleiro Pé-Duro, bem como a produção específica de IFN-γ por essas células em resposta à vacinação com BCG, através de citometria de fluxo. A resposta imune específica contra BCG também foi avaliada por teste tuberculínico, realizado antes e 45 dias após a vacinação. Para fins de comparação, os mesmos parâmetros foram investigados em bezerros da raça Nelore, uma raça bovina exótica com resistência demonstrado anteriormente. Naturalmente, animais da raça Curraleiro Pé-Duro apresentaram maiores níveis de CD4, CD8 e linfócitos gama-delta. Em resposta a vacina, Curraleiro Pé-duro mostrou maior capacidade de responder especificamente ao BCG, gerando perfil de resistência (Th1), evidenciado pelo maior número de células CD4+ específicas produtoras de IFN-γ e maior reação cutânea a por tuberculina. Os maiores níveis basais de linfócitos, maior produção de IFN-γ e reação cutânea à prova tuberculínica provavelmente desempenham um papel positivo na proteção/resistência ao Mycobacterium tuberculosis.
Subject(s)
Animals , Cattle , /analysis , /analysis , Interferons , T-Lymphocytes/immunology , Mycobacterium bovis/isolation & purification , Tuberculosis, Bovine/immunologyABSTRACT
Objective: To study the BCG vaccination scars among the under 5 year old internally displaced children in Vavuniya district. Study design: Cross sectional descriptive study Setting: Temporary settlement camps in Vavuniya district Method: All children between 6 to 60 months attending paediatric clinics held in the temporary settlement camps from 1st April to 15th May 2009 were included in the study. The interviewer administered questionnaire and examination of the child for the BCG scar were used to collect data. Results: One thousand and six children attending the clinics during the study period were analyzed. Nine hundred and seventy five children received BCG vaccination whilst vaccination data for 31 patients was not available. One hundred and fifty three children did not have a visible scar. Conclusion: Fifteen percent of under 5 year old internally displaced children in Vavuniya district did not have BCG scars.
ABSTRACT
La tuberculosis meníngea (MTB) es la enfermedad tuberculosa extrapulmonar más frecuente en los países del tercer mundo, incluida Colombia, y tiene tasas altas de morbilidad y mortalidad. En este artículo se presenta una revisión de la literatura sobre los siguientes aspectos de la enfermedad: clínicos, epidemiológicos, de laboratorio, tomográficos, terapéuticos y de prevención con la vacuna BCG.
Tuberculous meningitis is the most frequent extrapulmonary form of tuberculosis in underdeveloped countries, among them Colombia. It is associated with high rates of morbidity and mortality. In this article a review is presented of the following aspects of the disease: clinical, epidemiological, therapeutic, prophylactic by means of BCG vaccination, laboratory diagnosis, and tomographic findings.
Subject(s)
Child , Morbidity/trends , Mycobacterium tuberculosis , Tuberculosis, Meningeal , BCG Vaccine , Developing CountriesABSTRACT
Mycobacterial Spindle cell Pseudotumor (MSP) is a rare complication of mycobacterial infection, especially the atypical variety. It is characterized by an exuberant spindle cell proliferation. This has been reported in the lymph nodes, skin, spleen, lungs, brain, etc. The incidence is higher in immuno-compromised patients, especially those with acquired immunodeficiency syndrome. It is rare to encounter this lesion in infants. We report a case of MSP in the axillary lymph node of a 7-month-old infant, following Bacillus Calmette Guerin (BCG) vaccination due to Mycobacterium tuberculosis complex, which was proved by PCR.
ABSTRACT
Tuberculid is thought to develop as a hypersensitive immunologic reaction in the skin to an occult internal focus of tuberculosis. Lichen scrofulosorum (LS) is a rare tuberculid, which usually develops in children and young adults. Rarely, lichen scrofulosorum can be caused by Bacillus Calmette-Guerin (BCG) vaccination. With the increasing use of BCG inoculation, several complications have been reported. However, there have been no reports of lichen scrofulosorum following BCG vaccination in the Korean literature. We report a case of lichen scrofulosorum developing after BCG vaccination.
Subject(s)
Child , Humans , Young Adult , Bacillus , Lichens , Mycobacterium bovis , Skin , Tuberculosis , Tuberculosis, Cutaneous , VaccinationABSTRACT
PURPOSE: The most effective and basic Tb preventive measure is BCG vaccination. Even though the Intradermal vaccination method in BCG vaccination is known to be the most accurate method in preventing the advanced Tb, nowdays most of the Korean civilian hospitals utilize multipuncture BCG vaccination method ,which is quite contrary to the national standard intradermal vaccination method. Therefore I decided to inform and educate the pregnant women who would be in a position to choose the BCG vaccination method. This will help them understand the BCG vaccination methods properly. We should urge the intradermal method which is acknowledged as the national standard vaccination method. METHODS: The questionnaire was mailed twice to 214 pregnant women requring the antenatal care who visited any of the 9 health centers in Busan from the period of Aug to Oct. 2007. The 1st questionnaire was done in 214 pregnant women prior to education concerning the BCG vaccination methods and Tb, and the 2nd questionnaire was done after education. Contents of the questionnaire were general knowledges for BCG vaccination method, intention of selection for BCG vaccination, knowledges for the adverse effect, etc. Data analysis was performed utilizing SPSS (ver12) and the pregnant women's change in concept was comparatively analyzed with percentage, chi-square -test . RESULTS: Considering the general characteristics of the pregnant women who participated in the study, the highest percentage was noticed in their 15-28 gestational weeks (60.8%), Age over 30 (70.1%), Education level-college graduate (76.6%). Recognition to the presence of two types BCG vaccination method was 27.6% before education and 95.3% after education which showed a marked improvement (p=0.0001). After education, 82.2% of pregnant women decided to choose intradermal BCG vaccination method at birth which was 23.4% before education (p=0.0003). Despite the fact that intradermal BCG method is the national standard vaccination method, some of them prefer multipuncture BCG vaccination method, because most of the scars (41.3%), the civilian hospitals do it (35.7%), because of the lack of the education and information from the health centers and public institutions (17.4%). The future selection of BCG vaccination methods as follows: before education, intradermal BCG vaccination 31.0%, multipuncture BCG vaccination 14.6%, uncertain 54.4%, and after education, intradermal BCG vaccination 72.4%, multipuncture BCG vaccination 2.8%, uncertain 24.8% (p<0.0001). CONCLUSIONS: The pregnant women were not fully aware of intradermal and multipuncture BCG vaccination methods. Through education and information, it was possible for them to thoroughly recognize the BCG vaccination methods. In order to urge the intradermal BCG vaccination method, the health centers and public institutions need to educate and inform the pregnant women regarding the intradermal BCG vaccination method which is the standard vaccination method in Korea.
Subject(s)
Female , Humans , Cicatrix , Intention , Mycobacterium bovis , Parturition , Postal Service , Pregnant Women , Statistics as Topic , Vaccination , Surveys and QuestionnairesABSTRACT
A 10-month-old male patient was seen with a nodular lesion on his left upper arm which developed several months after BCG vaccination. Physical examination revealed a bean sized, irregular surfaced, erythematous pustular nodule on the left upper arm at a place different from the vaccination site. Histopathologic examination of the nodule on the left upper arm showed tubercles composed of mononuclear cells, epithelioid cells and langhans type giant cells in the dermis. Caseation necrosis within the typical tubercles was noted. Prominent improvement of the lesion was observed 4 months after oral medication with isoniazid and rifampicin.
Subject(s)
Humans , Infant , Male , Arm , Dermis , Epithelioid Cells , Giant Cells, Langhans , Hypogonadism , Isoniazid , Mitochondrial Diseases , Mycobacterium bovis , Necrosis , Ophthalmoplegia , Physical Examination , Rifampin , Tuberculosis, Cutaneous , VaccinationABSTRACT
BCG is a live attenuated vaccine derived from Mycobacterium bovis. It can give rise to several cutaneous complications including benign and malignant tumors. There are many reports about tumors arising in vaccination sites, especially those of small pox and BCG vaccinations. Reported tumors are basal cell carcinoma, dermatofibroma, melanoma, pilomatricoma and so on. Piloleiomyoma is a rare soft tissue tumor arising from arrector pili muscles. Clinically, piloleiomyomas appear as firm dermal papules and nodules with skin colored, pink, or reddish-brown surfaces. We experienced a case of piloleiomyma arising in a BCG vaccination site, which has not been reported in previous literature. Although several hypotheses have been propsed, there are no identified causes of leiomyoma. Trauma by the vaccination, persistent inflammation, wound healing process, or antigenic stimulation of the innoculation agent could be the possible causes in this case.
Subject(s)
Carcinoma, Basal Cell , Histiocytoma, Benign Fibrous , Inflammation , Leiomyoma , Melanoma , Muscles , Mycobacterium bovis , Pilomatrixoma , Skin , Vaccination , Wound HealingABSTRACT
Generalized granuloma annulare is defined as affecting at least the trunk and either the upper or lower extremities, or both. It is represented by disseminated necrobiotic dermal papules forming annular or nonannular configuration. Clinical associations between generalized granuloma annulare and diabetes mellitus, thyroid disease, malignancy, infection, and vaccination have been reported. BCG vaccination induces specific and nonspecific dermatologic complications such as scrofuloderma-like, lupus vulgaris-like, tuberculid, urticaria, erythema multiforme, erythema nodosum, and granuloma annulare. Generalized granuloma annulare associated with BCG vaccination or tuberculin test has not been reported in the Korean literature. Herein, we report a case of generalized granuloma annulare which occurred in a 6-month-old boy following BCGitis on the BCG vaccination site.
Subject(s)
Humans , Infant , Diabetes Mellitus , Erythema Multiforme , Erythema Nodosum , Granuloma , Granuloma Annulare , Lower Extremity , Mycobacterium bovis , Thyroid Diseases , Tuberculin Test , Tuberculosis, Cutaneous , Urticaria , VaccinationABSTRACT
The adverse effects of BCG vaccination span diversely from systemic to local reactions. However, the adverse effects of BCG vaccination on the skin are rare and these can appear as non-specific or specific skin reactions. We experienced two cases of non-specific skin reaction, which occurred on a vaccine-injected site. Eczematous lesions with the clinical and pathological findings have not previously been report in the English dermatologic literature. Herein, we present two interesting cases of non-specific skin reactions from dermatological complications of BCG vaccination.
Subject(s)
Mycobacterium bovis , Skin , VaccinationABSTRACT
PURPOSE: During the childhood, Mantoux test is very popular for detecting tuberculous infection and also useful for evaluating the immunity against tuberculosis after BCG vaccination. But the response and conversion rate is affected by the age of vaccination, the quality of vaccine, the duration after vaccination and the frequency of the test. Recently percutaneous multipuncture technique of BCG vaccination was introduced and used because of local side effect and technical problem of intradermal BCG vaccination, however there is only a study of conversion rate and side effect at 3month after multipuncture BCG vaccination. We performed this study to evaluate of the difference of the Mantoux reaction and conversion rate according to duration (3month, 9month and 15month) after vaccination, gestational age, sex, and feeding type. METHODS: 174 neonates (155 of full term infants, 19 of preterm infants) who were born Kangnam St. Mary's Hospital were given multipuncture BCG vaccination within 4weeks after birth between July, 1995 and June 1997. All subjects was performed Mantoux test using 5TU PPD (NIH, Korea) at 3month, 9month and 15month. Injecting BCG and interpretating the result of the Mantoux test was done by the same person. RESULTS: 1) The positive rates of Mantoux test which was done 3month , 9month and 15month after vaccination were 38.7%, 58.1%, 71.6% in the full term infant group and 31.6%, 31.6%, 47.4% in the preterm infant group. 2) The size of induration in Mantoux test, which was done 3month, 9month and 15month after vaccination were 7.3 mm, 9.4 mm, and 10.6 mm in the full term infant group and 5.6 mm, 7.7 mm, 9.2 mm in the preterm infant group. The size of induration was significantly lower in the preterm infant group as compared with that of the full term infant group 9month after vaccination. 3) The positive conversion rate, less than 5 mm to more than 10 mm, was 6.3% (3 infants of 48 infants who were negative Mantoux test 3month became positive 9month) and 26.3% (5 infants of 19 infants who were negative 9month became positive 15month) in the full term infant group, and 33.3% (one infant of 5 infants who were negative 9month became positive 15month). 4) There is no difference in conversion rate of Mantoux test according to the sex, feeding type in both groups5) Complication rate for multipuncture is 3.2%, which is leaded by local ulceration and fever in the full term infant group, and 5.3%, which is only fever in the preterm infant group. CONCLUSION: In those result the size of induration and conversion rate is increased as the duration after vaccination, then their smaller size in the preterm group 9month after vaccination maybe due to immunological immaturity of preterm group.
Subject(s)
Humans , Infant , Infant, Newborn , Fever , Gestational Age , Infant, Premature , Mycobacterium bovis , Parturition , Tuberculosis , Ulcer , VaccinationABSTRACT
Tuberculosis of the bone and joints is either one of the generalized manifestation or solitary localized lesion. The involvement of bone after Bacille Calmette Guerin (BCG) vaccination is very rare. We experienced a case of which developed tuberculous osteomyelitis after BCG vaccination. The case is a 14-month-old male. The patient had the history of BCG vaccination 1 year ago. The presenting symptoms were swelling, redness and discharge of the left shoulder. The lesion in the left proximal humerus was mainly erosive lesion with minimal periosteal reaction. We are going to report a case of 14-month-old child with tuberculous osteomyelitis after BCG vac-cination with brief review of literature.
Subject(s)
Child , Humans , Infant , Male , Humerus , Joints , Mycobacterium bovis , Osteomyelitis , Shoulder , Tuberculosis , VaccinationABSTRACT
PURPOSE: Tuberculosis, a major public health problem, is an important cause of childhood morbidity and mortality in developing countries. To decline the tuberculosis morbidity rate, active BCG vaccination is performed worldwide. Recently percutaneous multiple puncture technique of BCG vaccination was introduced and used because of side effects of intradermal BCG vaccination such as scar, local ulceration, regional suppurative lymphadenitis. We studied the difference of positive conversion rates and side effect after intradermal BCG vaccination and percutaneous multiple puncture technique BCG vaccination. METHODS: Three hundred seventy one infants, who were vaccinated at well baby clinic of Soonchunhyang University Hospital and performed tuberculin skin test using 5TU PPD (NIH, Korea) at 4month, were divided two groups; group I of 257 infants immunized percutaneous multiple puncture technique BCG (Japan BCG Laboratory, Japan) and group II of 174 infants immunized intradermal BCG (Institute Meri ux, France). RESULTS: 1) Sixtysix point five percent of male infants and 72.4% of female infants were vaccinated percutaneous multiple puncture technique BCG (Group I) 2) The positive conversion rate was 97.7% in group I and 76.3% in group II (p<0.05). 3) The positive conversion rate vaccinated within 2 weeks after birth were 97.9%, 2-4weeks 97.8%, 5-6weeks 95.2% in group I, and within 2 weeks 73.5%, 2-4weeks 75.8%, 5-6weeks 83.3% in group II. 4) The mean induration of positive conversions were 10.6+/-2.8mm in group I and 9.3+/-2.7mm in group II, that of Group I was significantly higher than that of groupII (p<0.05). 5) The complications of BCG vaccination were fever, generalized rash, and local ulceration in group I, fever, severe irritability in groupII. But there was no significant difference in two groups. CONCLUSIONS: The infants of vaccinated with percutaneous multiple puncture technique showed larger size of mean induration and higher positive conversion rate after PPD and less scar after vaccination compared with intradermal method. Further studies is necessary to find out the optimum time for BCG vaccination by percutaneous multiple puncture technique to provide the better immunity.
Subject(s)
Female , Humans , Infant , Male , Cicatrix , Developing Countries , Exanthema , Fever , Lymphadenitis , Mortality , Mycobacterium bovis , Parturition , Public Health , Punctures , Skin Tests , Tuberculin Test , Tuberculin , Tuberculosis , Ulcer , VaccinationABSTRACT
PURPOSE: Ugly ulcer and keloid formation of injection site has sometimes been a problem in Korea from the cosmetic point of view in intradermal vaccination. Since 3 or 4 years ago, multipuncture BCG vaccination has been used in Korea, there are no data and information about multipuncture BCG vaccination. We therefore performed this study to evaluate of conversion rate, complication and to make criteria of horizontal induration of Mantoux test instead of erythema to use criteria of positive Mantoux test in Japan. METHODS: 124 neonates who were born Kon-Kuk university hospital without family history of tuberculosis were given multipuncture BCG vaccination within 4 weeks after birth between Mar. and Oct. 1995. We observed change of local lesion for 1-3 months after BCG vaccination. All neonates tested a Mantoux test with 5TU of PPD 3 months after multipuncture BCG vaccination. RESULTS: 1) There was no significant difference in conversion rate of Mantoux test by feeding pattern. 2) There was no change of number of puncture site 1-3 months after BCG vaccination. 3) There was no ulcer in change of local lesion. Pusture, scab and redness was decreased 3 months after multipuncture BCG vaccination. Redness of all was replaced pigmentation. 4) The means+/-2SD of diameters of induration, erythema on Mantoux test were 10.4+/-3.0mm in horizontal induration, 13.2+/-4.2mm in horizontal erythema, 8.0+/-3.0mm in vertical induration, 10.9+/-3.5mm in vertical erythema. 5) Criteria for positive tuberculin reaction were diameters of induration, erythema : equal to or greater than 7mm of horizontal induration, equal to or greater than 5mm of vertical induration, equal to or greater than 10mm of horizontal and vertical erythema. 6) The positve conversion tuberculin rate were 87.8% in horizontal induration, 87.5% of vertical induration, 83.8% of horizontal erythema, 69.4% of vertical erythema. 7) Conversion rate of neonates immunized later 21 days after birth were significantly greater than neonates immunized within 21 days after birth. 8) There was no correlate Mantoux test conversion rate and strong reaction of local lesion. 9) There were no specific complication after multipuncture BCG vaccination. 10) There were no severe pain and irritability at multipuncture BCG vaccination. CONCLUSIONS: Multipuncture BCG is a good BCG vaccination that we can use with efficacious effect and slight local lesions instead of intradermal BCG vaccination.
Subject(s)
Humans , Infant, Newborn , Erythema , Feeding Behavior , Japan , Keloid , Korea , Mycobacterium bovis , Parturition , Pigmentation , Punctures , Tuberculin , Tuberculosis , Ulcer , VaccinationABSTRACT
PURPOSE: During the childhood, Mantoux test is very popular for detecting tuberculous infection and also useful for evaluating the immunity against tuberculosis after BCG vaccination. But the response and conversion rate is affected by the age of vaccination, the quality of vaccine, the duration after vaccination and the frequency of the test. This study was performed to investigate the difference of the response and conversion rate, according to duration after vaccination, gestational age, sex and feeding type. METHODS: The subject was included 85 of infants (71 of full term infants, 14 of preterm infants) and was followed up 3 months, 9 months, 15 months after vaccination, from July, 1992 to June, 1994 in Kangnam St. Mary's Hospital. We injected intradermally the BCG vaccine (0.05ml) which was produced by National Institute of Health and PPD (5TU) was used as a testing material of Mantoux test. Injecting BCG and interpreting the result of the Mantoux test was done by the same person. RESULTS: 1) The positive conversion rates of Mantoux test which was done 3 month, 9 month and 15 month after vaccination were 26.8%, 53.5% and 60.6% in the full-term infant group, and 14.3%, 28.6%, and 50% in the preterm infant group. The conversion rate was significantly lower in preterm infant group as compared with that of the full-term infant group 3 months after vaccination. 2) The sizes of induration in Mantoux test, which was done 3 month, 9 month and 15 month after vaccination, are 7.2mm, 8.5mm, 9.4mm in the full-term infant group and 5.0mm, 6.6mm, 8.2mm in the preterm infant group. The size of induration was significantly lower in the preterm infant group as compared with that of the full-term infant group. 3) There is no difference in conversion rate of Mantoux test according to the sex, feeding type in both groups. 4) Complication rate for BCG vaccine is 9.9%, which is leaded by lymphadenitis, persistent ulcer, and febrile abscess as the order, in the full-term infant group and there are no complications in the preterm infant group. CONCLUSIONS: In those results, the size of induration and conversion rate is increased as the duration after vaccination, then lower conversion rate in the preterm infant group 3 months after vaccination may be due to immunological immaturity of preterm infant.
Subject(s)
Humans , Infant , Infant, Newborn , Abscess , BCG Vaccine , Gestational Age , Infant, Premature , Lymphadenitis , Mycobacterium bovis , Tuberculosis , Ulcer , VaccinationABSTRACT
Dermatologic complications attributed to BCG vaccination are rarely seen. We report a case of widespread skin tuberculosis following BCG vaccination. A 28-year old female visited our outpatient clinic because of erythematous plaques and atrophic patches on the upper chest, both axillae, neck and frontal scalp. Her skin lesion had developed on the right shoulder after BCG vaccination.18 years ago, and gradually extended. She was treated under the impression of psoriasis at private clinic for recent 2 years, but her skin lesions were aggravated. Tuberculin skin test revealed positive reaction. Histopathologic examinations from scalp, posterior neck and axilla revealed granulomatous structures composed of giant cells, epithelioid cells and lymphoid cells in the dermis, but tubercle bacilli were not found in AFB stain. After 9 months of treatment with antituberculous medications such as streptomycin, isoniazid, rifampin and ethambutol, her skin lesions were almost healed.
Subject(s)
Female , Humans , Ambulatory Care Facilities , Axilla , Dermis , Epithelioid Cells , Ethambutol , Giant Cells , Isoniazid , Lymphocytes , Mycobacterium bovis , Neck , Psoriasis , Rifampin , Scalp , Shoulder , Skin Tests , Skin , Streptomycin , Thorax , Tuberculin , Tuberculosis, Cutaneous , VaccinationABSTRACT
A 14-year-old female patient was seen with a nodular lesion on her left shoulder which developed one month after BCG vaccination. Physical examination revealed a thumb tip sized, irregular surfaced, erythematous scar-like plaque on the left shoulder, and a 2.5cm diameter, movable, subcutaneous nodule without surface change on the left axilla. Histopathologic examination of the plaque on the left shoulder and axillary nodule showed tubercles composed of mononuclear cells, epithelioid cells and giant cells of the Langhans type in the dermis. Caseation necrosis within the typical tubercles was noted. Prominent resolution of the lesion was observed 4 months after oral medication with isoniazid and ethambutol. The subcutaneous axillary nodule which developed after BCG vaccination was thought to be an unusual manifestation of skin tuberculosis.