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Successful Handling of Disseminated BCG Disease in a Child with Severe Combined Immunodeficiency
Sílvia Bacalhau1, Cristina Freitas, Rosalina Valente
1Pediatric Intensive Care Unit, Hospital Dona Estefânia, 1169-045 Lisboa, Portugal.
Insights
Bacillus Calmette-Guérin (BCG) vaccination prevents tuberculosis in high-risk newborns. However, disseminated BCG disease can occur in infants with primary immunodeficiency, necessitating revised vaccination strategies in non-endemic regions.
Area of Science:
- Immunology
- Vaccinology
- Infectious Diseases
Background:
- Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccination is standard for preventing severe Mycobacterium tuberculosis infection in newborns in high-burden countries.
- Disseminated BCG disease poses a life-threatening risk to infants with primary immunodeficiency disorders.
Observation:
- A case report details a patient diagnosed with X-linked severe combined immunodeficiency (SCID).
- This patient subsequently developed disseminated BCG disease post-vaccination.
Findings:
- The case highlights the critical risk of disseminated BCG disease in infants with underlying immunodeficiencies, such as SCID.
- Specific management strategies were successfully implemented for this patient.
Implications:
- The findings underscore the need to re-evaluate BCG vaccination strategies in non-high-burden countries.
- Consideration of primary immunodeficiency screening prior to BCG vaccination may be warranted in specific populations.
Abstract:
In high-burden countries, Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccine is administered in newborn to prevent severe Mycobacterium tuberculosis infection. Because life-threatening disseminated BCG disease may occur in children with primary immunodeficiency, vaccination strategy against tuberculosis should be redefined in non-high-burden countries. We report the case of a patient with X-linked severe combined immunodeficiency (SCID) who developed disseminated BCG disease, highlighting the specific strategies adopted.
