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Extra-pulmonary tuberculosis in BCG-vaccinated patients

S P Lamabadusuriya1, P Keembiyehetty, T Pathirana

  • 1Department of Paediatrics, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.

Journal of Tropical Pediatrics
|June 1, 1992
PubMed

Insights

BCG vaccination did not prevent extra-pulmonary tuberculosis in six Sri Lankan children. Five developed miliary tuberculosis and one bone tuberculosis despite early vaccination, prompting a discussion on BCG vaccine failure.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Tuberculosis (TB) remains a global health challenge, particularly in endemic regions.
  • Bacillus Calmette-Guérin (BCG) vaccination is widely used to prevent severe forms of childhood tuberculosis.
  • Extra-pulmonary tuberculosis (EPTB) encompasses TB outside the lungs, often posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To present cases of pediatric extra-pulmonary tuberculosis in Sri Lanka.
  • To investigate the occurrence of EPTB in infants despite BCG vaccination.
  • To discuss potential reasons for BCG vaccine failure in preventing EPTB.

Main Methods:

  • Retrospective case review of pediatric patients presenting with EPTB.
  • Analysis of vaccination history, specifically BCG status at birth.
  • Clinical and epidemiological data collection for six patients over a two-year period.

Main Results:

  • Six pediatric patients with EPTB were identified within a two-year timeframe.
  • All six patients had received BCG vaccination at birth.
  • Five patients developed miliary tuberculosis, and one developed bone tuberculosis.

Conclusions:

  • BCG vaccination may not offer complete protection against all forms of extra-pulmonary tuberculosis in certain populations.
  • Further research is needed to understand the factors influencing BCG vaccine efficacy against EPTB.
  • The findings highlight the importance of continued vigilance for EPTB in vaccinated children in high-incidence areas.

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