CLINICAL MANAGEMENT OF LOCALIZED BCG ADVERSE EVENTS IN CHILDREN.
BCG adverse events (BCG-AE) are rare conditions with no well-established treatment. This study aims to describe clinical characteristics and outcome of localized BCG-AE. Children with BCG-AEs who were treated at the Reference Center for Special Immunobiologicals of the Federal University of São Paulo from 2009 to 2011 were included. Patients were followed monthly until 3 months after healing. One hundred and twenty-seven patients with localized BCG-AE were followed: 67 (52.7%) had suppurative lymphadenitis; 30 (23.6%) injection-site abscess; five (3.9%) had enlarged lymph node > 3 cm; four (3.1%) had ulcer > 1 cm; and one (0.8%) had a local bacterial infection. Five patients (3.9%) had more than one BCG-AE simultaneously. Fifteen patients (11.8%) had atypical manifestations: seven wart-like lesions; five BCG reactivations; two other dermatologic lesions and one with vasomotor phenomenon. Isoniazid was used in 96 patients with typical BCG-AE (85.7%) until lesion resolution which took place 3.1 months later (in median); the healing rate was 90.6%. Patients with atypical manifestations had an individual approach. Regarding the outcome, 105/112 patients with typical AE and 13/15 patients with atypical AE had resolution of BCG-AE. Localized BCG-AE caused by BCG Moreau RJ had positive outcome when treated with a short course of isoniazid. Atypical BCG-AE are not infrequent.
Reference Center for Special Immunobiologicals, Division of Pediatric Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil.
Thais das Neves Fraga
TN
Moreira
Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
Maria Isabel de
MI
Moraes-Pinto
Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.
Beatriz Tavares
BT
Costa-Carvalho
Outpatient Clinic of Recurrent Infections, Faculty of Medicine ABC, Santo André, SP, Brazil.
Anete Sevciovic
AS
Grumach
Reference Center for Special Immunobiologicals, Division of Pediatric Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil.
Lily Yin
LY
Weckx
D001500:BCG Vaccine / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008199:Lymphadenitis / Q000209:etiology; D008297:Male
D001500:BCG Vaccine