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Title: Clinical management of localized bcg adverse events in children
Authors: Moreira, Thais das Neves Fraga [UNIFESP]
de Moraes-Pinto, Maria Isabel [UNIFESP]
Costa-Carvalho, Beatriz Tavares [UNIFESP]
Grumach, Anete Sevciovic
Weckx, Lily Yin [UNIFESP]
Keywords: Bcg Vaccine
Adverse Event
Mycobacterium BovisSevere Combined Immunodeficiency
Calmette-Guerin Vaccine
Issue Date: 2016
Publisher: Ios Press
Citation: Revista Do Instituto De Medicina Tropical De Sao Paulo. Sao paulo, v. 58, p. UNSP 84, 2016.
Abstract: BCG adverse events (BCG-AE) are rare conditions with no well-established treatment. This study aims to describe clinical characteristics and outcome of localized BCG-AE. Children with BCG-AEs who were treated at the Reference Center for Special Immunobiologicals of the Federal University of Sao Paulo from 2009 to 2011 were included. Patients were followed monthly until 3 months after healing. One hundred and twenty-seven patients with localized BCG-AE were followed: 67 (52.7%) had suppurative lymphadenitis
30 (23.6%) injection-site abscess
five (3.9%) had enlarged lymph node > 3 cm
four (3.1%) had ulcer > 1 cm
and one (0.8%) had a local bacterial infection. Five patients (3.9%) had more than one BCG-AE simultaneously. Fifteen patients (11.8%) had atypical manifestations: seven wart-like lesions
five BCG reactivations
two other dermatologic lesions and one with vasomotor phenomenon. Isoniazid was used in 96 patients with typical BCG-AE (85.7%) until lesion resolution which took place 3.1 months later (in median)
the healing rate was 90.6%. Patients with atypical manifestations had an individual approach. Regarding the outcome, 105/112 patients with typical AE and 13/15 patients with atypical AE had resolution of BCG-AE. Localized BCG-AE caused by BCG Moreau RJ had positive outcome when treated with a short course of isoniazid. Atypical BCG-AE are not infrequent.
ISSN: 0036-4665
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