Shai Shrot1,2, Galia Barkai3, Aviva Ben-Shlush4, Michalle Soudack4,5. 1. Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel. shaishrot@gmail.com. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. shaishrot@gmail.com. 3. Pediatric Infectious Diseases Unit, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. 4. Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel. 5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: When administered to an immune-compromised patient, BCG (Bacille Calmette-Guérin) can cause disseminated and life-threatening infections. OBJECTIVE: To describe the imaging findings in children with primary immunodeficiency and BCG-related infections. MATERIALS AND METHODS: We reviewed the imaging findings of children with primary immunodeficiency treated at a children's hospital during 2012-2014 with localized or disseminated BCG infection. Imaging modalities included US, CT and radiography. RESULTS: Nine children with primary immunodeficiency had clinical signs of post-vaccination BCGitis; seven of these children showed disseminated disease and two showed only regional lesions with characteristic ipsilateral lymphadenopathy. Overall, lymphadenopathy was the most prevalent feature (n = 8) and characteristically appeared as a ring-enhancing hypodense (CT) or hypoechoic (US) lesion. Visceral involvement with multiple abscesses appeared in the spleen (n = 2), liver (n = 1) and bones (n = 1). All lesions regressed following appropriate anti-tuberculosis treatment. CONCLUSION: BCG infection needs to be considered in children with typical findings and with suspected primary immunodeficiency.
BACKGROUND: When administered to an immune-compromised patient, BCG (Bacille Calmette-Guérin) can cause disseminated and life-threatening infections. OBJECTIVE: To describe the imaging findings in children with primary immunodeficiency and BCG-related infections. MATERIALS AND METHODS: We reviewed the imaging findings of children with primary immunodeficiency treated at a children's hospital during 2012-2014 with localized or disseminated BCG infection. Imaging modalities included US, CT and radiography. RESULTS: Nine children with primary immunodeficiency had clinical signs of post-vaccination BCGitis; seven of these children showed disseminated disease and two showed only regional lesions with characteristic ipsilateral lymphadenopathy. Overall, lymphadenopathy was the most prevalent feature (n = 8) and characteristically appeared as a ring-enhancing hypodense (CT) or hypoechoic (US) lesion. Visceral involvement with multiple abscesses appeared in the spleen (n = 2), liver (n = 1) and bones (n = 1). All lesions regressed following appropriate anti-tuberculosis treatment. CONCLUSION: BCG infection needs to be considered in children with typical findings and with suspected primary immunodeficiency.
Authors: P Sharifi Asadi; A Aghamohammadi; S Mahmoudi; B Pourakbari; F Saboui; S Mamishi Journal: Allergol Immunopathol (Madr) Date: 2014-06-16 Impact factor: 1.667