菌根 Calmette-Guérin (BCG) 相关的椎骨髓炎可能是由 Mycobacterium bovis 引起的
Belkis Hatice Inceli1, Döndü Nilay Penezoglu1, Halil Özdemir1
1Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, TUR.
Cureus
|February 27, 2025
概括
接种疫苗后的骨髓炎是一种罕见的Bacillus Calmette-Guérin (BCG) 疫苗并发症,可以呈现异常. 这一案例突出了一个被诊断为BCG相关的乳房骨髓颗粒性骨质炎的儿童,并成功地用抗生素治疗.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 疫苗学 疫苗学 疫苗学
背景情况:
- 菌卡尔梅特-盖林 (BCG) 疫苗被广泛用于预防结核病.
- 虽然BCG接种通常是安全的,但可能会导致罕见的并发症,包括骨髓炎,特别是在健康的儿童中.
- 由于其非典型的临床表现,BCG后骨髓炎的延迟诊断是常见的.
研究的目的:
- 在健康的婴儿中报告BCG相关的粒状骨髓炎的罕见病例.
- 为了强调诊断挑战和成功管理这种罕见的疫苗并发症.
主要方法:
- 在BCG疫苗接种后,一个11个月大的男孩的病例研究显示,胸壁胀.
- 诊断成像包括胸部计算机断层扫描 (CT) 和磁共振成像 (MRI).
- 细针吸血活检和Mycobacterium bovis培养的组织病理学检查证实了诊断.
主要成果:
- 图像检测显示了胸骨的光学变化与相关的软组织异常.
- 组织病理学证实了与BCG感染一致的粒状骨质炎.
- 从活检中分离出了Mycobacterium bovis. 这是一个很好的例子.
- 患者对四种药物抗生素疗法 (伊索尼亚齐德,利芬素,乙墨托尔,西普罗夫洛克萨) 的反应良好,在一个月内观察到90%的病变缩.
结论:
- 与BCG相关的骨髓炎是一种罕见但重要的疫苗接种并发症.
- 通过成像和活检进行早期诊断对于有效的管理至关重要.
- 及时的抗生素治疗带来了良好的结果和显著的病变回归.
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