Severe osteomyelitis as a complication of Tokyo-172 BCG vaccination.
The bacilli Calmette-Guérin (BCG) Tokyo-172 strain was considered to exhibit good protective efficacy with a low rate of unfavorable side effects. However, we describe a rare case of BCG osteomyelitis developed in an immunocompetent host who was given with BCG Tokyo-172 vaccine on the left upper arm by multipuncture method. A 9-month-old girl presented with progressive inability to move her right elbow and had radiographic evidence of septic elbow combined with osteomyelitis of right distal humerus. A biopsy from the site revealed chronic caseating granulomatous inflammation, positive for BCG Tokyo-172 strain on the multiplex polymerase chain reaction. The child had to undergo second surgical debridements and oral antituberculosis chemotherapy. There were no sequelae after 2 yr of follow-up. This complication, although uncommon, should be considered in the appropriate clinical setting.
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hyo Jin
HJ
Kwon
Bo Hyun
BH
Chung
Byung Min
BM
Choi
Kyung Un
KU
Park
Yun Kyung
YK
Kim
D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000009:adverse effects*; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D060885:Multiplex Polymerase Chain Reaction; D009163:Mycobacterium bovis / Q000235:genetics / Q000302:isolation & purification*; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology* / Q000601:surgery
D000995:Antitubercular Agents; D001500:BCG Vaccine; D004269:DNA, Bacterial