Rapidly Progressive Disseminated Bacillus Calmette-Guérin Infection (BCGitis) in a 3-Month-Old Infant Without Immunodeficiency: A Case Report

Nathalya Queiroz Perillo ¹, Taynara Heliodoro ^2,3, Leandro Azevedo De Camargo ¹

⁰Department of Otolaryngology, Head and Neck Surgery, Hospital das Clínicas, Federal University of Goiás, Goiânia, GO, Brazil.

The American Journal of Case Reports +

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December 29, 2025

View abstract on PubMed

Summary

Disseminated Bacillus Calmette-Guerin (BCG) disease is a rare, fatal complication of BCG vaccination. Early recognition and a 7-month antibiotic regimen led to successful treatment in a previously healthy infant.

Area Of Science

Pediatrics
Infectious Diseases
Vaccinology

Background

Disseminated Bacillus Calmette-Guerin (BCG) disease is a severe, rare complication of BCG vaccination with high mortality.
It predominantly affects immunocompromised children, with incidence rates of 1.56-4.29 per million vaccinated individuals.
Typical lesions appear near the injection site, but rare presentations can occur.

Purpose Of The Study

To report a rare case of disseminated BCGitis with unusual head and neck involvement.
To highlight the diagnostic challenges and successful treatment of this severe complication.
To emphasize the importance of early recognition for improved patient outcomes.

Main Methods

Case report of a 3-month-old infant with disseminated BCGitis.
Clinical presentation, diagnostic investigations, and treatment regimen described.
Long-term follow-up to assess sequelae and neurodevelopment.

Main Results

The infant presented with extensive skin, subcutaneous, bone, lymphatic, and systemic complications in the head and neck.
The lesions mimicked malignant neoplasm due to rapid, destructive growth.
Successful treatment with a 7-month course of rifampicin, isoniazid, and ethambutol resulted in complete resolution without sequelae.

Conclusions

Disseminated BCGitis can manifest sporadically or as a sign of primary/secondary immunodeficiency.
Rapid progression and high fatality underscore the critical need for prompt diagnosis and intervention.
The case demonstrates that even severe presentations can be successfully managed with appropriate antimicrobial therapy.