BCG lymphadenitis: a potential complication of immune reconstitution following haematopoietic stem cell transplant

Arch Dis Child Educ Pract Ed. 2022 Aug;107(4):274-275. doi: 10.1136/archdischild-2020-320883. Epub 2020 Dec 18.

Abstract

An MHC class II deficient 2-year-old boy presented with fever and an enlarging left neck mass 100 days post allogeneic haematopoietic stem cell transplant (HSCT). Fever persisted despite treatment with broad-spectrum β-lactam antibiotics. His BCG vaccination site at presentation was quiescent. Ultrasound showed enlarged cervical lymph nodes. An incisional biopsy of the large nodal mass yielded acid-fast bacilli, identified as Mycobacterium bovis by genome sequencing. Treatment with rifampicin, isoniazid and pyridoxine was started. The mass suppurated (figure 1), before healing concurrently with T-lymphocyte reconstitution at approximately day 130 post-HSCT.

Keywords: HIV; cell biology; genetics; pathology; syndrome.

Publication types

  • Case Reports

MeSH terms

  • BCG Vaccine / adverse effects
  • Child
  • Child, Preschool
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Immune Reconstitution*
  • Infant, Newborn
  • Isoniazid / therapeutic use
  • Lymphadenitis* / chemically induced
  • Lymphadenitis* / therapy
  • Male
  • Rifampin

Substances

  • BCG Vaccine
  • Isoniazid
  • Rifampin