Antibacterials/BCG vaccine/immune globulin
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Antibacterials/BCG vaccine/immune globulin Disseminated BCG infection and lack of efficacy: 7 case reports
In a retrospective study (study period: between January 2016 and December 2019), 7 neonates [2 girls and 5 boys; exact ages not stated] were described, who developed disseminated BCG infection in the setting of BCG vaccination. Two of these 7 patients died of disseminated BCG infection despite treatment with linezolid, immune globulin or unspecified antibiotics [dosages not stated; not all routes and outcomes stated]. The patients underwent BCG vaccination. Patients had underlying primary immunodeficiency diseases (PIDs), including severe combined immunodeficiency (SCID), chronic granulomatous disease (CGD) or Mendelian susceptibility to mycobacterial disease (MSMD). The patients developed disseminated BCG infections due to BCG vaccines with manifestations of diarrhoea, pneumonia, spleen abscess, recurrent ulceration in BCG vaccination site, skin eruptions, liver abscess, bone destruction, multiple lesions in the brain, left subaxillary lymph node enlargement, microcephaly, growth retardation, skin eruptions, left cervical lymph node enlargement, multiple lymph node enlargement, recurrent fever or pleural effusion. These manifestations started after birth or in the first month of birth. Further manifestations continued to develop between 2 and 9 months of age. The patients were treated with linezolid, IV immune globulin [immunoglobulin], unspecified antibiotics, ertapenem, isoniazid, rifampicin, itraconazole or interferon-γ. Two of these 7 patients died of the disseminated BCG infections despite treatment with linezolid, IV immune globulin or unspecified antibiotics. Liu G, et al. Severe cases of BCGosis-susceptible primary immunodeficiency diseases identified by next-generation sequencing: Implications for adjustment of BCG vaccination timing in China. Journal of Genetics and Genomics 47: 229-232, No. 4, 20 Apr 2020
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Reactions 29 Aug 2020 No. 1819
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