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Disseminated BCG in an infant with interleukin-12 receptor B1 (IL12RB1) deficiency
Insights
Neonatal bacille Calmette-Guérin (BCG) vaccination complications in infants may signal primary immunodeficiency disorders. Early detection and treatment of interleukin-12 receptor beta 1 (IL12RB1) deficiency are crucial for recovery.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Neonatal bacille Calmette-Guérin (BCG) vaccination is standard but can cause disseminated disease in rare cases.
- Disseminated BCG infection is often linked to underlying primary immunodeficiency disorders, particularly in HIV-negative infants.
- A familial history of similar severe reactions to BCG vaccination warrants thorough investigation.
Abstract:
Although neonatal vaccination with bacille Calmette-Guérin (BCG) is considered to be safe, complications with disseminated disease are associated with underlying immuno-deficiency disorders. A BCG-vaccinated 4-month-old girl of Sri Lankan parentage developed progressive left axillary lymphadenopathy and severe bronchopneumonia. Lymph node biopsy demonstrated epithelioid granulomata and acid-fast bacilli. An older sibling had had a similar clinical presentation and the outcome had been fatal. Investigation for immuno-deficiency detected complete IL12RB1 deficiency. Full recovery followed a prolonged course of anti-tuberculous chemotherapy. She was put on lifelong isoniazid prophylaxis. In HIV-negative infants with unusual complications related to BCG vaccination, a primary immuno-deficiency disorder should be considered.
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