Disseminated tuberculoid lesions in infants following BCG vaccination

The records of 830 consecutive autopsies at Children's Hospital, Winnipeg revealed that 26 of the 36 infants (34 Canadian Indian, 1 Inuit and 1 Caucasian) given BCG vaccine shortly after birth had tuberculoid granulomas in various sites, including the vaccination site, regional lymph nodes, liver, spleen, lung, bone marrow and salivary gland. Mycobacterium bovis, BCG type, was identified in three of the four cases in which isolation was attempted. The principal causes of death had been sudden infant death syndrome and respiratory tract infections. None of the infants had histologic evidence of an immune deficiency. However, it is possible that in two cases the dissemination of BCG was enhanced by a temporary immunologic defect induced by malnutrition.