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Subcutaneous abscess in the lower leg caused by BCG-related osteomyelitis

Cheng-Kuang Chang1, Wei-Chou Chang, Herng-Sheng Lee

  • 1Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Southern Medical Journal
|June 10, 2010
PubMed

Insights

A rare case of tibial osteomyelitis in an infant was caused by Bacille Calmette-Guerin (BCG) vaccination. This led to bone destruction and a subcutaneous abscess, with MRI revealing the abscess formation mechanism.

Area of Science:

  • Pediatric Infectious Diseases
  • Skeletal Radiology
  • Molecular Diagnostics

Background:

  • Osteomyelitis is a serious bone infection.
  • Bacille Calmette-Guerin (BCG) vaccination is a common preventive measure against tuberculosis.
  • Complications from BCG vaccination, though rare, can occur.

Observation:

  • A 10-month-old infant presented with a painful mass near the tibia.
  • Radiographs revealed an osteolytic lesion in the proximal tibia.
  • Magnetic resonance imaging (MRI) showed a juxtacortical abscess connected to the bone.

Findings:

  • Surgical excision and polymerase chain reaction (PCR) confirmed tuberculous osteomyelitis.
  • The study details the mechanism of subcutaneous abscess formation secondary to BCG-related osteomyelitis.
  • MRI was crucial in visualizing the abscess and its connection to the tibial bone.

Implications:

  • Highlights a rare but significant complication of BCG vaccination.
  • Emphasizes the utility of advanced imaging like MRI in diagnosing complex bone infections.
  • Underscores the importance of PCR in identifying the causative agent in osteomyelitis.

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