Severe Osteomyelitis as a Complication of Tokyo-172 BCG Vaccination

• Published in: Journal of Korean medical science Vol. 27; no. 2; pp. 221 - 224
• Main Authors: Kwon, Hyo Jin, Chung, Bo Hyun, Choi, Byung Min, Park, Kyung Un, Kim, Yun Kyung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.02.2012; 대한의학회
• Subjects: Antitubercular Agents - therapeutic use; BCG Vaccine - adverse effects; Case Report; DNA, Bacterial - genetics; Female; Humans; Infant; Magnetic Resonance Imaging; Multiplex Polymerase Chain Reaction; Mycobacterium bovis - genetics; Mycobacterium bovis - isolation & purification; Osteomyelitis - drug therapy; Osteomyelitis - etiology; Osteomyelitis - microbiology; Osteomyelitis - surgery; 의학일반; Osteomyelitis; Bacilli Calmette-Guérin Vaccination; Complication
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2012.27.2.221

The bacilli Calmette-Guérin (BCG) Tokyo-172 strain was considered to exhibit good protective efficacy with a low rate of unfavorable side effects. However, we describe a rare case of BCG osteomyelitis developed in an immunocompetent host who was given with BCG Tokyo-172 vaccine on the left upper arm by multipuncture method. A 9-month-old girl presented with progressive inability to move her right elbow and had radiographic evidence of septic elbow combined with osteomyelitis of right distal humerus. A biopsy from the site revealed chronic caseating granulomatous inflammation, positive for BCG Tokyo-172 strain on the multiplex polymerase chain reaction. The child had to undergo second surgical debridements and oral antituberculosis chemotherapy. There were no sequelae after 2 yr of follow-up. This complication, although uncommon, should be considered in the appropriate clinical setting.