title: Disseminated Bacillus Calmette-Guérin (BCG) infection following allogeneic hematopoietic stem cell transplant in a patient with Bare Lymphocyte Syndrome type II.
abstract: We describe the first case, to our knowledge, of disseminated Mycobacterium bovis Bacillus Calmette-Guérin infection in a child with Bare Lymphocyte Syndrome type II after undergoing hematopoietic stem cell transplantation (HSCT). The patient presented 30 days post HSCT with fever and lymphadenitis. Lymph node, blood, and gastric aspirates were positive for M. bovis. The patient received a prolonged treatment course with a combination of isoniazid, levofloxacin, and ethambutol. Her course was further complicated by granulomatous lymphadenitis and otitis media associated with M. bovis that developed during immune suppression taper and immune reconstitution. Ultimately, the patient recovered fully, in association with restoration of immune function, and has completed 12 months of therapy.
authors.affiliation: Pediatric Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Abu-Arja
authors.forename: B E
authors.initials: BE
authors.lastname: Gonzalez
authors.forename: M R
authors.initials: MR
authors.lastname: Jacobs
authors.forename: L
authors.initials: L
authors.lastname: Cabral
authors.forename: R
authors.initials: R
authors.lastname: Egler
authors.forename: J
authors.initials: J
authors.lastname: Auletta
authors.forename: J
authors.initials: J
authors.lastname: Arnold
authors.forename: K R
authors.initials: KR
authors.lastname: Cooke
mesh_terms: D001500:BCG Vaccine / Q000009:adverse effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007223:Infant; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000382:microbiology*; D009163:Mycobacterium bovis; D016511:Severe Combined Immunodeficiency / Q000150:complications / Q000628:therapy
chemical_list: D001500:BCG Vaccine
keywords: BCG infection; Bare Lymphocyte Syndrome II; HSCT; Mycobacterium bovis; pediatric transplant