Two cases of disseminated TB due to BCG vaccination and review of the related articles

ABSTRACT

Although BCG vaccination has many benefits, it can cause multiple complications. Disseminated TB is the most severe but rare complication of BCG vaccination. Osteomyelitis is another important complication. Usually these complications are due to a defect in immune system. Rapid diagnosis and treatment can be life saving. The first case was a 3 month old boy that was admitted in hospital because of fever, lethargy and fistula in the right axillary area at the site of BCG vaccination. The second one was a 7 month old boy with an ulcer and a fistula at the site of BCG vaccination and chest wall. Diagnosis of disseminated TB was made by biopsy and culture. All immunologic investigations, except interleukin 12-gamma interferon pathway, were normal. When a child presents with lymphadenopathy and ulcer near the site of BCG vaccination, the physician must perform a complete physical examination to exclude diagnosis of disseminated TB, especially in the presence of long term low grade fever, organomegally, skin lesions and lack of weight gain