Bacillus Calmette-Guérin vaccine complications in Iranian children at a University Hospital.

BACKGROUND: Although the BCG vaccine remains the only available vaccine, a number of complications from local to systemic adverse reactions can occur. OBJECTIVE: The aim of the study was to review the clinical features and treatment of Bacillus Calmette-Guérin (BCG) complications in children. METHODS: Children with clinical and laboratory findings compatible with a diagnosis of local complication and disseminated disease at Masih Daneshvari Medical Center were enrolled from March 2013 to September 2015. RESULTS: Among 49 children with BCG complications, 35 (71%) had local complications and 14 (29%) had disseminated disease. The mean age at presentation was nine months (range: 1m-13y). The male to female ratio was 1.7:1. Suppurative lymphadenitis was seen in 25 of 35 (71%) cases. Among cases with disseminated disease, primary immunodeficiency (PID) was identified in nine (64%) cases. All cases with non-suppurative lymphadenitis were managed conservatively. Twenty (80%) cases with suppurative lymphadenitis were managed differently with medical treatment or surgery. In disseminated cases, three (43%) were treated with only medical treatment and eight (57%) with both medical and surgical treatment. CONCLUSIONS: Most children with BCG complications had a local disease in our study. A higher rate of disseminated disease was also observed. In addition, PID was identified in most children with disseminated disease. Development of more appropriate BCG vaccines and changing the current vaccination programme in cases with suspected PID are required in our country.

Contact tracing of a 15-year-old girl with smear-negative pulmonary tuberculosis in Tehran.

Early detection of tuberculosis (TB) cases and supervised treatment are vital for control of the disease. To assess TB transmission from a sputum smear-negative pulmonary TB case, the contacts of a 15-year-old Iranian girl diagnosed with smear-negative TB in 2010 were traced. In all, 52 classmates and close friends and 15 school staff were screened by tuberculin skin test and chest X-ray. Those with a positive skin test or abnormal chest X-ray were further evaluated by chest spiral computed tomography (CT) scan and triple gastric washing. All classmates and close friends were Iranian and female. Of the 52 girls, 17 (32%) had latent infection (either positive skin test or abnormal chest X-ray) and 3 (5.7%) had active TB (abnormal CT or positive culture additional to positive skin test or abnormal X-ray). None of the staff had abnormal findings. Contact tracing should be considered for contacts of all children with symptomatic pulmonary TB, even those who are smear-negative.

Contact tracing of a 15-year-old girl with smear-negative pulmonary tuberculosis in Tehran

Early detection of tuberculosis [TB] cases and supervised treatment are vital for control of the disease. To assess TB transmission from a sputum smear-negative pulmonary TB case, the contacts of a 15-year-old Iranian girl diagnosed with smear-negative TB in 2010 were traced. In all, 52 classmates and close friends and 15 school staff were screened by tuberculin skin test and chest X-ray. Those with a positive skin test or abnormal chest X-ray were further evaluated by chest spiral computed tomography [CT] scan and triple gastric washing. All classmates and close friends were Iranian and female. Of the 52 girls, 17 [32%] had latent infection [either positive skin test or abnormal chest X-ray] and 3 [5.7%] had active TB [abnormal CT or positive culture additional to positive skin test or abnormal X-ray]. None of the staff had abnormal findings. Contact tracing should be considered for contacts of all children with symptomatic pulmonary TB, even those who are smear-negative