Metastatic osteomyelitis following BCG vaccination

Generalized lymphadenitis following B.C.G. vaccination in an immunocompetent 12-year-old boy

An immunocompetent, healthy 12-year-old boy was presented with generalized large lymphadenopathy in the left side of the body, 1 month after a BCG vaccination with a regular dose. A Mantoux test before vaccination was negative. Histological and bacteriological findings from the largest lymph node biopsy revealed BCG'itis. The patient recovered spontaneously after 7 months. He was confirmed as being immunocompetent by normal serum immunoglobulin levels, normal B and T cell function tests, and a conversion of Mantoux test. BCG infections including lymphadenitis are rare and have been described hitherto mainly in infants, in immune deficient patients, or related to overdose. Such a complication must be taken into consideration when dealing with lymphadenopathy in healthy school-age children, who now undergo BCG vaccinations in many countries.

Recurrent mycobacterial osteomyelitis. Report of a case due to Mycobacterium avium-intracellulare-scrofulaceum complex and BCG vaccination

A 28-year-old man suffering from recurrent mycobacterial osteomyelitis during several years is reported. Eight years old he had a Mycobacterium scrofulaceum infection in his right calcaneus. A serious infection with multiple foci of osteomyelitis occurred after BCG vaccination at the age of 14 years and 11 years later multifocal lesions of osteomyelitis due to Mycobacterium avium-intracellulare-scrofulaceum complex appeared. The special clinical problems due to the relative or complete resistence of these organisms to antituberculous drugs are emphasized. The mainstays of treatment are surgical revision and drainage with prolonged and intensive multiple drug therapy.