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BCG osteomyelitis. Case report and review

K Schopfer, L Matter, C Brunner

    Helvetica Paediatrica Acta
    |January 1, 1982
    PubMed
    Summary
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    BCG osteomyelitis is a rare bone infection following BCG vaccination in newborns. This case highlights diagnostic and treatment challenges of this late-onset complication.

    Area of Science:

    • Pediatric infectious diseases
    • Orthopedic surgery
    • Vaccinology

    Background:

    • Bacille Calmette-Guérin (BCG) vaccination is widely used for tuberculosis prevention.
    • Osteomyelitis is a serious bone infection that can occur as a rare complication of BCG vaccination.
    • Late-onset BCG osteomyelitis, presenting months after vaccination, poses diagnostic and therapeutic challenges.

    Observation:

    • A 6-month-old boy developed BCG osteomyelitis affecting the distal femur (metaphysis and epiphysis).
    • The case illustrates the potential for BCG osteomyelitis to manifest significantly later than the vaccination period.
    • Review of 89 published records was conducted to analyze epidemiological, diagnostic, and therapeutic aspects.

    Findings:

    • BCG osteomyelitis can present as a late-onset complication of neonatal BCG vaccination.

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  • Diagnosis requires a high index of suspicion, especially in cases with prolonged symptoms.
  • Therapeutic strategies involve prolonged antimicrobial therapy and potentially surgical intervention.

    • Implications:

    • Increased awareness among clinicians regarding late-onset BCG osteomyelitis is crucial for timely diagnosis.
    • Further research is needed to optimize diagnostic criteria and treatment protocols for BCG osteomyelitis.
    • Understanding the epidemiology and management of this rare complication can improve patient outcomes.