Successful treatment of disseminated BCG infection in a SCID patient with granulocyte colony stimulating factor.
Severe combined immunodeficiencies (SCID) are disorders with impairment of humoral and cellular immune functions. The prognosis of disseminated bacillus Calmette-Guérin (BCG) infection in immunocompromised host is unfavorable since response to standard therapy is poor. We report a successful treatment of disseminated BCG infection with granulocyte colony stimulating factor (G-CSF) in a patient with severe combined immunodeficiency. The patient failed to response to intensive anti-tuberculous (anti-TB) therapy. After 2 months of G-CSF, in addition to anti-TB treatment, the clinical signs of disseminated BCG infection were improved. Since serious BCG infections in SCID are not uncommon in developing countries, where BCG vaccination is mandatory to all newborns, the combination of G-CSF and anti-TB drugs should be considered in immunocompromised patients with protracted mycobacterial infection.
Pariyaprasert
Wipada
W
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand.
Pacharn
Punchama
P
Visitsunthorn
Nualanong
N
Chokephaibulkit
Kulkanya
K
Sanpakit
Kleebsabai
K
Viprakasit
Vip
V
Vichyanond
Pakit
P
Jirapongsananuruk
Orathai
O
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D009163:Mycobacterium bovis; D016511:Severe Combined Immunodeficiency / Q000150:complications*; D014376:Tuberculosis / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D001500:BCG Vaccine; D016179:Granulocyte Colony-Stimulating Factor