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Sternal tuberculosis in a 9-month-old infant after BCG vaccination
Y Kato1, Y Horikawa, Y Nishimura
1Department of Pediatrics, National Hiroshima Hospital, Higashi-Hiroshima, Japan. Yasuhiro.Kato@mb7.seikyou.ne.jp
Insights
Tuberculosis osteitis can affect infants even after Bacillus Calmette-Guerin (BCG) vaccination. This case highlights sternal osteitis caused by Mycobacterium tuberculosis in a vaccinated infant, emphasizing the need for broader differential diagnoses.
Area of Science:
- Pediatrics
- Infectious Diseases
- Osteology
Background:
- Tuberculosis osteitis typically presents as a late complication of pulmonary tuberculosis.
- Bacillus Calmette-Guerin (BCG) vaccination is a common preventive measure against tuberculosis in infants.
- Infantile osteitis localization in the sternum is rare, especially in BCG-vaccinated individuals.
Observation:
- A 9-month-old Japanese infant, vaccinated with BCG at 3 months, presented with a sternal tumor.
- The infant had no respiratory symptoms, and the source of infection remained unclear.
Findings:
- Mycobacterium tuberculosis complex was identified in the sternal lesion via nucleic acid amplification testing.
- Gastric aspirates also confirmed the presence of Mycobacterium tuberculosis.
Implications:
- This case represents the first reported instance of tuberculous osteitis localized to the sternum in an infant.
- Tuberculous osteitis must be considered in the differential diagnosis of undiagnosed bone lesions in infants, irrespective of BCG vaccination status.
Unlabelled:
Tuberculosis osteitis is mainly observed as a late complication of the pulmonary infection. We describe a 9-mo-old Japanese infant who became infected with Mycobacterium tuberculosis even after receiving Bacillus Calmette-Guerin (BCG) vaccination at 3 mo of age. This is the first report that the sternum is the localization for tuberculous osteitis in infants. He developed a localized tumor in the sternum without any respiratory symptom. Mycobacterium tuberculosis complex was detected by means of nucleic acid amplification test. Gastric aspirates also yielded Mycobacterium tuberculosis. The source of the infection was unclear.
Conclusion:
Tuberculous osteitis should be excluded in infants with undiagnosed bone lesions, even if they have been vaccinated with BCG.