Cure of bacille Calmette-Guérin vaccination abscesses with erythromycin

Postvaccination subcutaneous abscess due to bacille Calmette-Guérin (BCG) is an uncommon complication and is especially rare in the United States, where the general population is not vaccinated with BCG. This type of abscess is usually chronic, and optimal therapy has not been defined. Two Americans, a husband and wife, underwent primary BCG vaccination abroad and developed chronic subcutaneous abscesses at the primary inoculation site. Four months after vaccination, Mycobacterium bovis strain BCG was cultured from material aspirated from both lesions. Direct susceptibility studies revealed a minimal inhibitory concentration of less than 3.0 micrograms of erythromycin/mL for both isolates. Erythromycin was given orally to the husband and wife for 3 and 4 weeks, respectively, during which time complete healing occurred in both cases.