Case Report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn's disease.
We present the case of a 28 year old lady with refractory Crohn's Disease treated with infliximab throughout her pregnancy. Her baby was born healthy and received a Bacillus Calmette-Guérin (BCG) vaccine aged 3 months. Soon after this the infant became unwell and died aged 4.5 months. At post-mortem the cause of death was attributed to an unusual complication of the BCG vaccine, known as disseminated BCG. BCG vaccination is contraindicated in individuals who are receiving immunosuppressive drugs. We recommend physicians should exercise caution before such vaccines are used in infants born to mothers taking anti-TNF therapies or other potentially immunosuppressive IgG1 antibodies.
Department of Gastroenterology, Ealing Hospital NHS Trust, Middlesex, UK.
Kuldeep
K
Cheent
Jonathan
J
Nolan
Sohail
S
Shariq
Liina
L
Kiho
Arabinda
A
Pal
Jayantha
J
Arnold
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D001500:BCG Vaccine / Q000009:adverse effects*; D000075202:Contraindications; D003424:Crohn Disease / Q000188:drug therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007223:Infant; D000069285:Infliximab; D008297:Male; D009164:Mycobacterium Infections / Q000209:etiology; D009163:Mycobacterium bovis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014611:Vaccination / Q000009:adverse effects
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D001500:BCG Vaccine; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab