[Mild form of Lyell's syndrome as an consequence of inappropriate BCG revaccination--case report]

In this case report a rare adverse event (mild toxic epidermic necrolysis (Lyell)) was described. Incorrect a purified protein derivative (PPD) administration involves false negative tuberculin test (TT): BCG vaccine was injected even though high immunization to BCG. Mild, benign epidermic necrolysis, fever, mononucleosis-like syndrome, splenomegaly and lymphadenopathy were observed. Evaluation of white blood cells was done by automatic (simultaneously two analysers: Baker 900 plus and Technicon, Bayer) and by microscopic methods and revealed high lymphocyte activation (blastic transformation), lymphocytosis and high eosinophilia.. Wiener and coworkers describe interleukin-2-induced dermatotoxicity resembling toxic epidermal necrolysis. Further the most common side effects of IL-2 are skin eruptions and eosinophilia. Careful analysis yielded the conclusions that Lyell's syndrome may be fatal consequence of inappropriate revaccination, hyperergia--delayed type hypersensitivity and massive IL-2 release. Successful dexamethasone therapy confirms this observation.