title: Clinical, laboratory and imaging findings of the patients with disseminated bacilli Calmette-Guerin disease.
abstract: OBJECTIVE
  In the present study, we reviewed 44 cases of disseminated BCG infection during a 10-year period in an Iranian referral children medical centre hospital.
  
  
  METHODS
  In this study, all of the patients with clinical and laboratory findings that were compatible with a diagnosis of disseminated BCG were included.
  
  
  RESULTS
  Through 10 years evaluation, 44 patients were found with disseminated BCG disease. Hepatomegaly and splenomegaly were seen in 68% and 66% of patients, respectively. Osteomyelitis was observed in 9% of our cases. Decrease in blood cells including anaemia, leucopoenia, neutropenia and thrombocytopenia were associated with more severe disease and even deaths. Moreover, 80% and 70% of patients who died had high level of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Among the dead patients, 80% had abnormal sonography. Thirty nine percent of patients had immunodeficiency, while more than half of the patients who died had no identified immunodeficiency.
  
  
  CONCLUSIONS
  These findings confirm the need to do sonography as well as bone imaging immediately in all patients with BCGitis. Assessment of the inflammatory factors in order to predict the prognosis of the disease is recommended. Furthermore, complete blood count would provide important information and should perform in all patients with BCGitis.
authors.affiliation: Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: P
authors.initials: P
authors.lastname: Sharifi Asadi
authors.affiliation: Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Aghamohammadi
authors.affiliation: Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Mahmoudi
authors.affiliation: Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Pourakbari
authors.affiliation: Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Saboui
authors.affiliation: Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: smamishi@sina.tums.ac.ir.
authors.forename: S
authors.initials: S
authors.lastname: Mamishi
mesh_terms: D000740:Anemia / Q000209:etiology; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000382:microbiology*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D011379:Prognosis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D014463:Ultrasonography
chemical_list: D001500:BCG Vaccine; D002097:C-Reactive Protein
keywords: BCGitis; Clinical findings; Imaging; Laboratory results