title: BCG-itis in two antiretroviral-treated HIV-infected infants.
abstract: Although vaccination with Bacille Calmette-Guérin (BCG) is considered safe, adverse regional (BCG-itis) and disseminated (BCG-osis) diseases preferentially occur in the immunocompromised host. The infection with human immunodeficiency virus (HIV) by mother-to-child transmission leads to impaired cellular immune responses, a situation that poses a great challenge regarding the universal use of BCG vaccine. World Health Organization recommends that children who are known to be HIV-infected, even if asymptomatic, should no longer be immunized with BCG. Many of the complications of BCG vaccination occur in severely immunosuppressed HIV-infected children and are related to late institution of antiretroviral and antimycobacterial therapy. We report two cases of BCG-itis in HIV-infected infants, who fulfilled clinical criteria of immune reconstitution inflammatory syndrome: axillary adenitis, one with suppuration, and both temporally associated with precocious restoration of immunity elicited by the use of antiretroviral therapy. Isoniazid (10 mg/kg/day) was offered until regression of adenopathies, and lesions were not handled.
authors.affiliation: Municipal Program for the Surveillance of Sexually Transmitted Diseases and AIDS, Rio de Janeiro, Brazil. reg.fernandes@bol.com.br
authors.forename: R C
authors.initials: RC
authors.lastname: de Souza Campos Fernandes
authors.forename: E
authors.initials: E
authors.lastname: Medina-Acosta
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D044966:Anti-Retroviral Agents; D001500:BCG Vaccine