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BCGitis and BCGosis spectrum of imaging findings in immunocompromised pediatric patients
Latifah Alfahad1, Ayman Khushaim2, Waleed Alhabeeb3
1King Faisal Specialist Hospital & Research Centre, Takassusi, 3354, Riyadh, 11211, Saudi Arabia. latifah.alfahad@gmail.com.
Insights
The Bacille Calmette-Guérin (BCG) vaccine can cause infections, particularly in immunocompromised children. This review details imaging findings of BCG-related infections (BCGitis/BCGosis) and their link to immunodeficiency.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Immunology
Background:
- Tuberculosis (TB) remains a global health challenge.
- The Bacille Calmette-Guérin (BCG) vaccine prevents early-life TB but can cause adverse effects.
- Immunocompromised individuals are at higher risk for BCG-related infections.
Purpose of the Study:
- To review the imaging spectrum of BCG-vaccine-related infections in immunocompromised pediatric patients.
- To illustrate localized (BCGitis) and disseminated (BCGosis) forms of BCG infection.
- To highlight distinct imaging patterns in various affected sites.
Main Methods:
- Pictorial review of imaging findings.
- Analysis of BCG-vaccine-related infections in immunocompromised children.
- Correlation of imaging findings with clinical context.
Main Results:
- Common findings include lymphadenopathy and solid organ involvement.
- Less frequent sites like lungs and gastrointestinal tract show distinct patterns.
- Imaging findings aid in diagnosing BCG infections and identifying underlying immunodeficiencies.
Conclusions:
- Radiological assessment is crucial for diagnosing BCG-vaccine-related infections in immunocompromised children.
- Imaging findings can prompt further immunological investigation.
- Timely diagnosis and management are essential for favorable outcomes.
Abstract:
Tuberculosis (TB) remains a significant public health concern despite preventive measures, such as the use of the Bacille Calmette-Guérin (BCG) vaccine, which reduces the risk and severity of early-life TB infection. The adverse effects of the BCG vaccine include infection by the live-attenuated organism, more commonly seen in the immunocompromised host. This pictorial review aims to outline the imaging spectrum of BCG-vaccine-related infections in immunocompromised pediatric patients, which can be localized (BCGitis) or disseminated (BCGosis). We illustrate the more common imaging findings, including lymphadenopathy and involvement of solid organs, as well as less frequently encountered sites, such as the lungs and gastrointestinal tract, emphasizing their distinct imaging patterns. Interpretation of these findings in the context of prior administration of the BCG vaccine not only helps in the diagnosis of BCG-vaccine-related infections and guiding timely management, but can also be an early indicator of an underlying immunodeficiency disorder, prompting comprehensive immunological investigation.
