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Mycobacterial brain abscess possibly due to bacille Calmette-Guérin in an immunocompromised child

M J Coppes1, N F Olivieri, M Howes

  • 1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 1, 1992
PubMed

Insights

Disseminated bacille Calmette-Guérin (BCG) infection is rare, even in immunocompromised individuals. This case highlights BCG meningitis in a child with acute lymphoblastic leukemia, emphasizing the need for vigilance in susceptible populations.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Oncology

Background:

  • Disseminated bacille Calmette-Guérin (BCG) infection is an uncommon complication, typically seen in individuals with compromised cellular immunity.
  • BCG is used for immunotherapy and immunization, but can lead to disseminated disease in rare instances.

Observation:

  • A 6-year-old girl undergoing chemotherapy for acute lymphoblastic leukemia (ALL) presented with meningitis symptoms.
  • Cerebral biopsy identified acid-fast bacilli consistent with Mycobacterium bovis BCG.

Findings:

  • The patient had no prior BCG immunization or known exposure.
  • This suggests BCG meningitis can occur without prior immunization in immunocompromised hosts.

Implications:

  • This case underscores the importance of considering BCG infection in immunocompromised children presenting with neurological symptoms.
  • Prompt diagnosis and appropriate antimicrobial therapy are crucial for favorable outcomes in disseminated BCG infections.
  • Further research into risk factors and preventative strategies for BCG dissemination in immunocompromised patients is warranted.

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