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A CFSE-based Assay to Study the Migration of Murine Skin Dendritic Cells into Draining Lymph Nodes During Infection with Mycobacterium bovis Bacille Calmette-Guérin
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[Disseminated infection by Bacillus Calmette-Guérin in an immunodeficient infant: case report]

Consuelo Apagüeño-Ruiz1, Johanna Peceros-Escalante1, Reynaldo Pomar-Morante1

  • 1Instituto Nacional de Salud del Niño, Breña, Lima, Perú.

Revista Peruana De Medicina Experimental Y Salud Publica
|May 23, 2019
PubMed

Insights

The Bacillus Calmette-Guerin (BCG) vaccine can cause disseminated infection in infants with severe combined immunodeficiency (SCID). Early diagnosis of SCID is crucial for managing BCG-related complications in at-risk newborns.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Genetics

Background:

  • The Bacillus Calmette-Guerin (BCG) vaccine is widely administered to newborns in tuberculosis-endemic regions.
  • While generally safe, BCG can lead to local reactions or disseminated infections, particularly in immunocompromised individuals.

Observation:

  • A six-month-old infant presented with recurrent infectious nodules after BCG vaccination.
  • Histopathology and cultures revealed acid-alcohol-resistant bacilli (BAAR), identified as Mycobacterium bovis BCG.
  • Pulmonary opacities and BAAR in gastric lavage were noted; genetic analysis identified an IL2RG gene mutation, confirming severe combined immunodeficiency (SCID).

Findings:

  • Disseminated BCG infection in an infant with confirmed severe combined immunodeficiency (SCID).
  • Identification of Mycobacterium bovis BCG in skin lesions, lungs, and gastric lavage.
  • Confirmation of SCID due to an IL2RG gene mutation in the infant and mother.

Implications:

  • This case highlights the critical need for timely diagnosis of primary immunodeficiencies like SCID in infants presenting with unusual BCG-related complications.
  • Accurate and prompt diagnosis is essential for appropriate treatment and improved life prognosis in patients with disseminated BCG infection and SCID.
  • Understanding the interplay between BCG vaccination and severe combined immunodeficiency is vital for pediatric infectious disease management.

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