P Sharifi Asadi1, A Aghamohammadi2, S Mahmoudi3, B Pourakbari3, F Saboui1, S Mamishi4. 1. Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2. Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: smamishi@sina.tums.ac.ir.
Abstract
OBJECTIVES: In the present study, we reviewed 44 cases of disseminated BCG infection during a 10-year period in an Iranian referral children medical centre hospital. MATERIAL AND METHODS: In this study, all of the patients with clinical and laboratory findings that were compatible with a diagnosis of disseminated BCG were included. RESULTS: Through 10 years evaluation, 44 patients were found with disseminated BCG disease. Hepatomegaly and splenomegaly were seen in 68% and 66% of patients, respectively. Osteomyelitis was observed in 9% of our cases. Decrease in blood cells including anaemia, leucopoenia, neutropenia and thrombocytopenia were associated with more severe disease and even deaths. Moreover, 80% and 70% of patients who died had high level of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Among the dead patients, 80% had abnormal sonography. Thirty nine percent of patients had immunodeficiency, while more than half of the patients who died had no identified immunodeficiency. CONCLUSION: These findings confirm the need to do sonography as well as bone imaging immediately in all patients with BCGitis. Assessment of the inflammatory factors in order to predict the prognosis of the disease is recommended. Furthermore, complete blood count would provide important information and should perform in all patients with BCGitis.
OBJECTIVES: In the present study, we reviewed 44 cases of disseminated BCG infection during a 10-year period in an Iranian referral children medical centre hospital. MATERIAL AND METHODS: In this study, all of the patients with clinical and laboratory findings that were compatible with a diagnosis of disseminated BCG were included. RESULTS: Through 10 years evaluation, 44 patients were found with disseminated BCG disease. Hepatomegaly and splenomegaly were seen in 68% and 66% of patients, respectively. Osteomyelitis was observed in 9% of our cases. Decrease in blood cells including anaemia, leucopoenia, neutropenia and thrombocytopenia were associated with more severe disease and even deaths. Moreover, 80% and 70% of patients who died had high level of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Among the dead patients, 80% had abnormal sonography. Thirty nine percent of patients had immunodeficiency, while more than half of the patients who died had no identified immunodeficiency. CONCLUSION: These findings confirm the need to do sonography as well as bone imaging immediately in all patients with BCGitis. Assessment of the inflammatory factors in order to predict the prognosis of the disease is recommended. Furthermore, complete blood count would provide important information and should perform in all patients with BCGitis.