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Generalized BCG Infection with Fatal Course in an Infant
Author(s) -
GARDBORG ODD,
IVERSEN OLAV H.,
TORHEIM BERGLJOT J.,
HESSELBERG IVAR
Publication year - 1963
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1963.tb03782.x
Subject(s) - medicine , vaccination , tuberculosis , autopsy , incidence (geometry) , bcg vaccine , pediatrics , complication , immunology , surgery , pathology , physics , optics
SUMMARY A fatal case of generalized BCG infection following vaccination is reported. The patient, a girl BCG‐vaccinated at the age of six weeks, developed septic fever and leucocytosis at 5 1/2 months of age and died at 7 months of age in a poor condition with extensive edemas, icterus and severe attacks of general convulsions. Autopsy revealed disseminated tuberculosis. The histological picture showed little tendency to tuberculoid structure, marked caseous necrosis and myriads of acid‐fast bacilli in the affected areas. By bacteriological examination the acid‐fast bacilli were indistinguishable from BCG. Increased virulence or other changes in the BCG vaccine which might explain the fatal complication has not been found. Two of the patient's three siblings had previously shown definite signs of reduced resistance to infection, and both died at an early age from infections. Adding this to the patient's case history, one feels justified in concluding that a familial resistance impairment to infection is present. The cause of this deficiency is discussed. There are at present five known cases of fatal BCG infection following vaccination in Scandinavia, and the number of persons vaccinated is estimated to be between 6 and 7 millions. The probable incidence of fatal complications can thus be put at less than one case per million vaccinated. As the protective effect of BCG vaccination is beyond doubt and the serious complications extremely rare, there seems to be no ground at present for objecting to continued BCG vaccination.