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KMID : 0605820110180010091
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Korean Journal of Pediatric Infectious Diseases
2011 Volume.18 No. 1 p.91 ~ p.96
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A Case of Disseminated Mycobacterium bovis Infection after BCG Vaccination (Tokyo strain) in an Apparently Immunocompetent Infant
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Paik Ji-Yeun
Choi Jae-Hong
Kim Min-Kyung
Choi Eun-Hwa
Lee Hoan-Jong
Park Kyoung-Un
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Abstract
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Bacille Calmette-Guerin (BCG) vaccine is a live attenuated vaccine derived from Mycobacterium bovis. Frequent complications after BCG vaccination are localized ulcer formation and regional lymphadenitis, but there could be rarely severe systemic reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection. Although disseminated BCG infection can be complicated in infants with underlying immunodeficiency after BCG vaccination, it is very unlikely to develop in immunocompetent infants or children. We report a 13-month-old infant who presented with fever, skin nodules, and multiple enlarged lymph nodes 5 months following BCG vaccination. She was diagnosed with disseminated BCG infection by PCRconfirmed M. bovis BCG infection at ≥2 anatomical sites beyond the region of vaccination. The patient showed no obvious evidence of immunodeficiency as judged on the basis of previous disease history, plasma immunoglobulin levels, B and T lymphocytes counts in peripheral blood, DHR (dihydrorhodamine 123 fluorescence) test and HIV test. She started antituberculous treatment with isoniazid and rifampin, and now, apparently her symptoms have been improved.
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KEYWORD
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Disseminated BCG Infection, Mycobacterium bovis Infection, Immunocompetent patient
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