Osteitis secondary to BCG vaccine in immunocompetent patients: Three case reports.

Autor:	Saldaña NG; Service of Infectology, National Institute of Pediatrics (NIP), Mexico City., Ranero ARC; Service of Infectology, National Institute of Pediatrics (NIP), Mexico City., Trujillo DMG; Pediatric Infectious Disease Clinic, Cafam, Colombia., Garza EA; Service of Infectology, National Institute of Pediatrics (NIP), Mexico City., Tortoriello AIQ; Service of Infectology, National Institute of Pediatrics (NIP), Mexico City., Ruiz BV; Laboratory of Microbiology, National Institute of Nutrition and Medical Science., Jurado RR; Department of Anatomical Pathology, NIP., Olguín HJ; Faculty of Medicine, Department of Pharmacology, NIP, National Autonomous University of Mexico, Mexico., Silva ML; Faculty of Medicine, Department of Pharmacology, NIP, National Autonomous University of Mexico, Mexico.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2019 Jan; Vol. 98 (1), pp. e13871.
DOI:	10.1097/MD.0000000000013871
Abstrakt:	Rationale: Osteitis corresponds to a rare but potentially serious complication reported in pediatric population after the application of the Bacillus Calmette-Guerin (BCG) vaccine. In the present study, 3 clinical cases associated with this entity are reported. Patient Concerns: The 1st case corresponds to a 1-year-old female patient who presented an increase in the volume of the right pelvic limb after BCG application. The second case is a 2-year-old male who began with an increase in volume, overactive gait and pain at the level of the left knee on walking that began after a trauma in the left low limb. The 3rd case corresponds to a 3-year-old patient who started with intense pain and limitation for ambulation. Diagnosis: Both the radiographical and histological studies presented data suggestive of infection by Mycobacterium tuberculosis complex, corroborated through biopsy and genotyping analysis with the isolation of Mycobacterium bovis as the causal agent. Interventions: The basic treatment scheme was based on Ethambutol, Rifampicin, Pyrazinamide, and Isoniazid. When M. bovis was typified, clarithromycin was added in the treatment. Outcomes: Osteitis secondary to BCG vaccine usually has a favorable evolution, especially in immunocompetent patients. Lessons: It was possible to confirm the association of BCG vaccine with the clinical picture of the patients who presented improvement after the start of antimicrobial management. Osteitis secondary to BCG vaccine usually presents a favorable evolution, especially in immunocompetent patients; however, the involvement of joint, growth discs and vertebrae increases the risk of presenting long-term sequels.
Databáze:	MEDLINE
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