Disseminated Bacillus Calmette-Guerin (BCG) Infection in Severe Combined Immunodeficiency (SCID) Patients

Abstract

Disseminated Bacille Calmette-Guerin (BCG) infection is a rare and life-threatening complication of BCG vaccination. It is mainly seen in cases of severe immune deficiency. We report two cases of disseminated BCG infection in genetically proven cases of Severe Combined Immunodeficiency (SCID) from our institution. The first case is that of a one-year-old child who presented with fever, cough, yellowish discoloration of eyes, multiple skin nodules all over the body, and ulcer over the BCG vaccination site. Biopsy from the skin nodules showed multiple granulomas with plenty of Acid-fast bacilli; hence, anti-tubercular treatment was started for the child. The second case is that of a five-month-old child who presented with a lower respiratory tract infection, multiple episodes of loose stools, vomiting, poor feeding, poor activity, and a deranged Liver Function Test. Gastric aspirate Gene expert study was done and Mycobacterium tuberculosis was detected. Hence the patient was started on anti-tubercular treatment. Subsequent liver biopsy revealed a focus of granuloma. Genetic study was done in both cases and SCID was proved. Because of the rarity, we are presenting the cases.