four-month-old boy with fever, hepatosplenomegaly and diffuse pulmonary infiltrations

the (bacille calmette-gue´rin) bcg is widely practiced in many countries in pediatric group and is a part of routine vaccination program at birth in ir. iran for prophylaxis against tuberculosis, but its efficacy is a matter of debate in different geographic and ethnic regions. adverse reactions induced by bcg vaccination ranges from bcg adenitis, osteitis, and cold abscess at vaccination site to rare occurrence of disseminated infection (bcg-osis). this lethal disseminated disease specifically affects children with an immune deficiency and generally develops a few months after vaccination. we report one cases of disseminated bcg infection occurred in a 4 months old boy , with severe combined immunodeficiency and bcg-osis, which resulted from a consanguineous marriage with a history of two sibling death from severe infection . inoculation of bcg as a live vaccine should be postponed for a few months in suspected neonates of primary immunodeficiency disease, until appropriate screening tests exclude this diagnosis.