Complication of Bacillus Calmette-Guerin (BCG) Vaccine in HIV-infected Children

Nine of 355 cases of symtopmatic HIV-infected children who admitted to Chiang Mai University Hospital from January 1989 to December 1994 had complication due to BCG vaccination. The median age was 15 months with its range from 8 to 22 monts. Four cases presented with ulceration of the previously-healed BCG scar with ipsilateral enlarged and inflamed axillary nodes. Four cases had ipsilateral enlarged axillary nodes without ulceration of the previously healed BCG vaccination sites. One case had disseminated lesions including multiple lymphadenitis, draining abscess at left supraclavicular node, pulmonary with hilar lymphadenopathy. Although all cases responded initially to antituberculous treatment, four of them finally died. Two cases succumbed from respitatory failure and other two from brain atrophy. Though the outcome of BCG complications in normal hosts are usually favorable, our reported cases demonstrated evidence of aggressiveness of BCG strain used for vaccination. With the AIDS pandemic there is rising incidence of HIV-infected pregnant women and a corresponding rise in the incidence of HIV-infected infants for whom complication of BCG vaccination should be looked for and treated prompt;y. (J Infect Dis Antimicrobial Agents 1995;12:63-7). 63 Complication of Bacillus Calmette-Guerin (BCG) Vaccine in HIV-infected Children Virat Sirisanthana, M.D.*