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Disseminated BCG infection revealing a severe combined immunodeficiency: A case report

Hajer Ben Belgacem, Jihene Bouguila, Amel Tej

    La Tunisie Medicale
    |August 8, 2023
    PubMed

    Insights

    The Bacillus Calmette Guerin (BCG) vaccine can cause fatal disseminated infections in infants with undiagnosed primary immunodeficiency diseases. Early screening is crucial to prevent severe complications from BCG vaccination in at-risk newborns.

    Area of Science:

    • Pediatrics
    • Immunology
    • Infectious Diseases

    Background:

    • Bacillus Calmette Guerin (BCG) vaccination is standard for newborns in Tunisia.
    • BCG can cause severe local or disseminated disease in infants with primary immunodeficiency diseases (PIDs).

    Purpose of the Study:

    • To report a fatal case of disseminated BCG infection in an infant with severe combined immunodeficiency disease (SCID).
    • To emphasize the risk of BCG vaccination in undiagnosed PIDs.

    Main Methods:

    • Case report of a 3-month-old boy with persistent fever, hepatosplenomegaly, and osteolytic lesions.
    • Diagnosis of SCID and disseminated BCG infection.
    • Treatment with anti-tubercular therapy and intravenous immunoglobulin.

    Main Results:

    • The infant presented with symptoms consistent with disseminated BCG infection.
    • Despite treatment, the infant's condition was fatal.
    • The case illustrates a rare but lethal complication of BCG vaccination.

    Conclusions:

    • BCG vaccination poses a significant risk in infants with undiagnosed PIDs.
    • Screening for PIDs before BCG inoculation is recommended to prevent severe outcomes.
    • Postponing BCG vaccination until PIDs are ruled out can save lives.
    Abstract

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