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[Sternal osteomyelitis and scrofuloderma due to BCG vaccination]
Ivohne Fernanda Corrales1, Jorge Alberto Cortés, María Lucía Mesa
1Departamento de Pediatría, Universidad del Rosario, Bogotá, D.C., Colombia. ifcorrales@yahoo.com
Biomedica : Revista Del Instituto Nacional De Salud
|July 23, 2003
Summary
A rare adverse reaction to the Bacillus Calmette-Guérin (BCG) vaccine caused osteomyelitis and scrofuloderma in a 13-month-old girl. This case highlights potential complications even in immunocompetent individuals.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- The Bacillus Calmette-Guérin (BCG) vaccine is a widely used prophylactic against tuberculosis, with a long history of efficacy.
- Adverse reactions to the BCG vaccine are uncommon, but can occur, particularly in certain patient populations.
Observation:
- A 13-month-old infant, vaccinated with BCG as a newborn, presented with a sternal mass and periosteal erosion.
- Histopathological examination of the resected mass revealed chronic inflammation, caseous granulomas, and extension to bone and skin.
Findings:
- Polymerase chain reaction (PCR) analysis for Mycobacterium tuberculosis DNA in the tissue was negative.
- The clinical presentation, histological findings, and absence of M. tuberculosis DNA strongly suggested that the osteomyelitis and scrofuloderma were a direct consequence of the BCG vaccination.
Implications:
- This case underscores osteomyelitis as a rare but possible adverse effect of BCG vaccination, even in the absence of diagnosed immunodeficiency.
- It emphasizes the importance of considering BCG as a potential etiology for localized infections presenting with granulomatous inflammation and bone involvement in vaccinated infants.
- Further vigilance and investigation may be warranted in immunocompetent children presenting with unusual BCG-related complications.