A case of disseminated BCG infection in a daughter of Italian immigrants in Switzerland

  • Claudia Colomba Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
  • Raffaella Rubino Infectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
  • Manlio Tolomeo Infectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
  • Davide Lo Porto Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
  • Silvia Bonura Infectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
  • Stefano Agrenzano Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
  • Antonio Cascio Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
Keywords: Disseminated BCG infection, IFN-γR1 deficiency

Abstract

Bacillus Calmette-Guérin (BCG) is a vaccine against tuberculosis and contains a live, attenuated strain of Mycobacterium bovis as its essential constituent. Being a live, attenuated strain with potential pathogenicity, BCG can cause different complications, both near the inoculation site and through blood dissemination, especially in patients with immunodeficiency. IFN-γR1 deficiency is an autosomal recessively inherited immunodeficiency characterized by predisposition to infections with intracellular pathogens, in particular mycobacteria.

We report a rare case of chronic osteomyelitis lasting 30 years due to BCG in a woman with IFN-γR1 deficiency who had previous clinical history of multi-organ BCGitis. Diagnosis of chronic osteomyelitis was confirmed by an 18-fluorine fluorodeoxyglucose positron emission tomography combined with CT scan (18F-FDG PET/CT).

In children with a history of BCG vaccination and chronic unexplained infections, a clinical suspicion of BCG-related disease must arise, and a reason of immunodeficiency should be sought.

Published
2022-02-28
How to Cite
1.
Colomba C, Rubino R, Tolomeo M, Lo PortoD, Bonura S, Agrenzano S, Cascio A (2022) A case of disseminated BCG infection in a daughter of Italian immigrants in Switzerland. J Infect Dev Ctries 16:383-387. doi: 10.3855/jidc.15388
Section
Case Reports