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[The Calmette-Guérin bacillus (BCG). An agent to consider in pediatric infection]
F Marcelino1, G Vasconcellos, A Almeida
1Departamento de Pediatria, Hospital de S. João, Porto.
Insights
Delayed complications after Bacillus Calmette-Guérin (BCG) vaccination are rare but can occur. This case highlights BCG-induced osteitis in a child
Area of Science:
- Pediatric infectious diseases
- Vaccine-preventable disease complications
- Skeletal infections
Background:
- Bacillus Calmette-Guérin (BCG) vaccination is widely used for tuberculosis prevention.
- While generally safe, rare long-term complications can arise post-vaccination.
- Osteitis is a recognized, albeit infrequent, complication of BCG vaccination.
Observation:
- A previously healthy 15-month-old boy presented with a 3-week history of right foot enlargement.
- The swelling was unresponsive to empirical antibiotic treatment.
- Initial clinical presentation suggested a localized inflammatory or infectious process.
Findings:
- Diagnostic evaluation confirmed osteitis of the foot.
- Causative agent identified as Bacillus Calmette-Guérin (BCG).
- The osteitis resolved following targeted anti-BCG therapy.
Implications:
- BCG-induced osteitis should be considered in the differential diagnosis of pediatric bone lesions, especially after vaccination.
- Prompt diagnosis and specific treatment are crucial for favorable outcomes.
- This case underscores the importance of recognizing rare vaccine-related complications in pediatric practice.
Abstract:
Complications occurring a long time after BCG vaccination in healthy children have been occasionally referred, despite being rare. Osteitis seems to be the most frequent of those complications; therefore it must be considered in the differential diagnosis of that sort of lesions. The authors report a case of a 15 month old boy, previously healthy, who suffered an enlargement of the right foot for 3 weeks, unresponsive to antibiotics. The lesion revealed to be osteitis due to bacillus Calmette-Guérin, and abated after specific treatment.