A toddler’s osteitis of the left upper limb after BCG vaccination: A Case report
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH - Year 2018, Vol 10, Issue 7
Abstract
Introduction: Serious complications following vaccination with BCG are rare. Among these complications, osteitis is of particular interest because it is more common and appears to occur in immune competent patients. Despite the diagnostic criteria proposed by Foucard and Hjelmsted in 1971, post-vaccination BCG osteitis is rarely recognized in pediatric practice, with only 25% of cases being diagnosed. Observation: We report the case of a 12-month-old infant, who presented to pediatric emergencies for partial functional impotence of the upper left limb, evolving for 2 months in a context of apyrexia and of conservation of the general state. The patient was vaccinated with BCG at day 15 of life. The injection site was the left deltoid. The dose and type of vaccine used was not specified. He had not had any local post-vaccination complications, nor recent trauma of the limb, and there was no known tuberculous contusion in the environment. Results: On examination, the infant had pain while the stretching the left arm, relieved by the limb against trunk position. The palpation had found a firm, painless, non-inflammatory mass of the anterior aspect of the upper third of the left arm. The radiograph of the left shoulder had revealed a lytic metaphyseal-diaphyseal left humeral image. MRI showed a lesion process of the upper extremity of the aggressive left humerus with invasion of neighboring structures. A bone biopsy performed had objectified granulomatous osteitis without caseous necrosis. The tuberculin IDR was phlyctenular, reaching 18 mm. The rest of the balance sheet looking for other locations was negative. Anti-bacillary triple therapy (rifampicin, pyrazinamide, isoniazid) was started. The evolution after 6 months of treatment remains favorable, with persistent apyrexia, preserved appetite, and weight gain of 3 kilograms. Conclusion: Osteitis after BCG vaccination is a rare, underestimated and difficult to diagnose. It should be considered in small children who have already received BCG vaccination, have had no contact with tubercolosis and have clinical findings consistent with osteitis, but do not respond to conventional antibiotics. It has a better prognosis, with a good response to anti-bacillary and surgical treatment. Clinical trials are needed to codify therapeutic management.
Authors and Affiliations
Nassih, H.
Keywords
Related Articles
- EP ID EP403631
- DOI -
- Views 132
- Downloads 0
Utility of serological tests for the clinical diagnosis of celiac Disease in children in diyala province
Background: Celiac disease (CD) is an immune-mediated systemic condition triggered by dietary gluten occurring in genetically susceptible individuals. CD has a wide range of clinical manifestations. A number of serologic...
Hypereosinophilic Hyper Ige Syndrome – A Rare Case Report
Hyper immunoglobulin (Ig) E syndrome is a rare complex immunoregulatory disorder characterized by hyperglobulinemia, recurrent bacterial infections and chronic eczematous dermatitis. The onset of this syndrome may occur...
Evaluation of a ct head radiation dose reduction protocol in children using anatomical delineation, diagnostic confidence and imaging quality of ct brain as parameters
Objective: To evaluate a CT head radiation dose reduction protocol in children using anatomical delineation, diagnostic confidence and imaging quality of CT brain as parameters. Method: The study prospectively reviewed h...
Gastroprotective effects of loranthus micranthus and acalypha wilkesiana leaves extracts on experimentally induced ulcer models in rats
The anti-ulcer activities of Loranthus miranthus leaf extract (LOME) and Acalypha wilkesiana leaf extract (AWLE) were investigated in rats in which ulcer was induced with indomethacin (40mg/kg). Results obtained indicate...
Volkmann’s ischaemic contracture: a sequlae to bonesetting
The case study has been done to evaluate volkmann’s ischaemic contracture (vic) which is one of the common complications caused as a result of bone setting. This paper presents a report of a young male who developed this...