title: Bacillus Calmette-Guérin-related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series.
abstract: BACKGROUND
  Thigh swelling in an infant can be a symptom of a simple benign condition or a life-threatening condition. We observed a cluster of thigh swelling episodes in infants in which the cause was Bacillus Calmette-Guérin-related cold thigh abscess. We report this unusual case series to raise awareness about this diagnosis.
  
  
  METHODS
  We performed a retrospective review of five infants (four boys and one girl) who presented with Bacillus Calmette-Guérin-related left thigh abscess. The swelling was noticed by the parents at a mean period of three months prior to presentation. The ages at presentation were five, five, eight and nine months for the boys, and six months for the girl. All of the patients were healthy Saudi infants, and received the Bacillus Calmette-Guérin vaccine at birth. Clinically, all of the patients were well and did not demonstrate signs of systemic infection. All patients underwent needle aspiration, with subsequent incision and drainage in four of the five cases. The cultures obtained from the abscess fluids were the key to establishing the diagnosis. Only three patients (60%) received antituberculosis drugs. Wound healing lasted for a mean period of approximately seven months. Two-year follow-up was unremarkable for all of our patients.
  
  
  CONCLUSIONS
  Technical errors continue to be significant in the development of vaccine-related complications. Bacillus Calmette-Guérin-related cold thigh abscess is an extremely rare entity.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. mnamshan@hotmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al Namshan
authors.forename: Omar
authors.initials: O
authors.lastname: Oda
authors.forename: Jameela
authors.initials: J
authors.lastname: Almaary
authors.forename: Saud
authors.initials: S
authors.lastname: Al Jadaan
authors.forename: Stanley
authors.initials: S
authors.lastname: Crankson
authors.forename: Esam
authors.initials: E
authors.lastname: Al Banyan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al Shaalan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zamakhshary