[Clinical analysis of 18 children with disseminated Bacille Calmette-Guérin infection].
OBJECTIVE
To explore the clinical manifestation, immune abnormality and outcome of disseminated Bacille Calmette-Guérin (BCG) infection in children.


METHODS
The clinical data of 18 children with disseminated BCG infection seen from January 2000 to December 2007 were analyzed retrospectively.


RESULTS
Thirteen of the children were male among 18 patients. Disseminated infection first appeared in armpit lymph nodes ipsilateral to the vaccination site, then spread to lungs in 15, lymphnodes of mediastinum or abdominal cavity in 18, skin and soft tissues in 5, skeletons in 4, liver in 4, spleen in 8, kidney, adrenal gland or meninges in 3. Twelve children were diagnosed to have primary immunodeficiency; 3 had severe combined immunodeficiency (SCID); 7 had chronic granulomatous disease (CGD), 2 had IL-12/IFN-gamma passageway deficiency. Eleven of the 18 patients died, and the remaining 7 patients were followed up from 1 to 9 years and are alive at present, but presented recurrent skin and bone tuberculosis in 4 and recurrent other infection in 3.


CONCLUSIONS
Most Children with disseminated BCG infection had primary immunodeficiency. CGD and IL-12/IFN-gamma passageway deficiency accounted for considerable proportion, so special immune function should be detected in these patients. The prognosis was poor. The type of the immunodeficiency diseases should be identified in early stage and the specific immune treatment should be given to the patients.
Li
Hui-min
HM
Department of Internal Medicine, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Zhao
Shun-ying
SY
He
Jian-xin
JX
Jiang
Zai-fang
ZF
D001500:BCG Vaccine / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000209:etiology; D007223:Infant; D008198:Lymph Nodes; D008297:Male; D009163:Mycobacterium bovis / Q000472:pathogenicity*; D012189:Retrospective Studies; D014376:Tuberculosis / Q000276:immunology / Q000382:microbiology* / Q000473:pathology*
D001500:BCG Vaccine