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[BCG-infection in chronic granulomatous disease (author's transl)]
Insights
A boy developed chronic infections after BCG vaccination, later diagnosed with Granulomatous Disease (GCD). Treatment with Sulfamethoxazol-Trimethoprim significantly reduced infection rates, improving his health.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- BCG vaccination is a standard procedure for tuberculosis prevention.
- Chronic suppurative processes can arise post-vaccination, requiring careful diagnosis.
Observation:
- A 7-year-old boy presented with a chronic suppurative process at the BCG vaccination site, spreading to the neck and chin, with supraclavicular lymphadenopathy.
- Histological examination confirmed tuberculosis, leading to a five-year tuberculostatic therapy.
Findings:
- During treatment, the patient experienced recurrent bacterial infections, granulomatous inflammation, and pulmonary complications (fibrous pneumonitis, cor pulmonale).
- A negative Nitroblue tetrazolium (NBT) test at age 6 enabled the diagnosis of Chronic Granulomatous Disease (GCD).
Implications:
- Early diagnosis of GCD is crucial for managing recurrent infections.
- Prompt and appropriate antimicrobial therapy, such as Sulfamethoxazol-Trimethoprim, can effectively control infections in GCD patients.
Abstract:
A 7 year old boy developed in the newborn period a chronic suppurative process after routine BCG vaccination beginning at the site of the injection and spreading to the adjacent areas on neck and chin. A supraclavicular lymphadenopathy was also noted. Serial histological examinations revealed the typical histopathological pattern of tuberculosis and the boy received a tuberculostatic therapy for five years. During this time he suffered from multiple chronic bacterial infections which led to chronic granulomatous inflammations in different organs and to a fibrous pneumonitis with subsequent cor pulmonale. At the age of 6 years a negative NBT-test allowed the diagnosis of GCD. Consequently therapy with Sulfamethoxazol-Trimethoprim was started and the rate of infections diminished markedly.