title: BCGitis and BCGosis in children with primary immunodeficiency - imaging characteristics.
abstract: BACKGROUND
  When administered to an immune-compromised patient, BCG (Bacille Calmette-Guérin) can cause disseminated and life-threatening infections.
  
  
  OBJECTIVE
  To describe the imaging findings in children with primary immunodeficiency and BCG-related infections.
  
  
  METHODS
  We reviewed the imaging findings of children with primary immunodeficiency treated at a children's hospital during 2012-2014 with localized or disseminated BCG infection. Imaging modalities included US, CT and radiography.
  
  
  RESULTS
  Nine children with primary immunodeficiency had clinical signs of post-vaccination BCGitis; seven of these children showed disseminated disease and two showed only regional lesions with characteristic ipsilateral lymphadenopathy. Overall, lymphadenopathy was the most prevalent feature (n = 8) and characteristically appeared as a ring-enhancing hypodense (CT) or hypoechoic (US) lesion. Visceral involvement with multiple abscesses appeared in the spleen (n = 2), liver (n = 1) and bones (n = 1). All lesions regressed following appropriate anti-tuberculosis treatment.
  
  
  CONCLUSIONS
  BCG infection needs to be considered in children with typical findings and with suspected primary immunodeficiency.
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel. shaishrot@gmail.com.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. shaishrot@gmail.com.
authors.forename: Shai
authors.initials: S
authors.lastname: Shrot
authors.affiliation: Pediatric Infectious Diseases Unit, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Galia
authors.initials: G
authors.lastname: Barkai
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel.
authors.forename: Aviva
authors.initials: A
authors.lastname: Ben-Shlush
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michalle
authors.initials: M
authors.lastname: Soudack
mesh_terms: D001500:BCG Vaccine / Q000009:adverse effects*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007223:Infant; D008199:Lymphadenitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D001500:BCG Vaccine
keywords: Bacille Calmette-Guérin; Bone; Children; Computed tomography; Infection; Liver; Lymphadenopathy; Mycobacterium; Severe combined immunodeficiency; Spleen; Ultrasound