Danish bacille Calmette-Guérin vaccine-induced disease in human immunodeficiency virus-infected children.
An analysis of isolates of Mycobacterium tuberculosis complex was performed to determine the prevalence of bacille Calmette-Guérin (BCG) disease among human immunodeficiency virus (HIV)-infected children. Speciation was done with polymerase chain reaction; 183 isolates from mycobacterial cultures for 49 HIV-infected patients were analyzed. The Danish Mycobacterium bovis BCG strain was isolated from 5 patients. No cases of Tokyo M. bovis BCG strain disease were detected. All patients were asymptomatic at birth, <12 months of age, and severely immunodeficient at presentation. Four patients had regional axillary adenitis ipsilateral to the vaccination site, and 2 had pulmonary BCG disease. Two patients with regional BCG disease had simultaneous pulmonary M. tuberculosis infection. Although chest radiographic features were similar to those seen in patients with tuberculosis, BCG disease should be considered in HIV-infected infants with right axillary adenitis ipsilateral to the vaccination site. Young, symptomatic, HIV-infected infants are at risk for BCG-related complications. Controlled, population-based studies are needed to assess the risk of BCG in HIV-infected children.
Hesseling
A C
AC
Centre for Tuberculosis Research and Education, Department of Pediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg Children's Hospital, Cape Town, South Africa. annekeh@sun.ac.za
Schaaf
H S
HS
Hanekom
W A
WA
Beyers
N
N
Cotton
M F
MF
Gie
R P
RP
Marais
B J
BJ
van Helden
P
P
Warren
R M
RM
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D001500:BCG Vaccine / Q000009:adverse effects*; D002648:Child; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D009163:Mycobacterium bovis / Q000737:chemistry* / Q000302:isolation & purification; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014376:Tuberculosis / Q000209:etiology*
D001500:BCG Vaccine