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Rapidly Progressive Disseminated Bacillus Calmette-Guérin Infection (BCGitis) in a 3-Month-Old Infant Without

Nathalya Queiroz Perillo1, Taynara Heliodoro2,3, Leandro Azevedo De Camargo1

  • 1Department of Otolaryngology, Head and Neck Surgery, Hospital das Clínicas, Federal University of Goiás, Goiânia, GO, Brazil.

The American Journal of Case Reports
|December 29, 2025
PubMed

Insights

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.

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