Disseminated BCG Disease in an Infant with Severe Combined Immunodeficiency

BCG (Bacillus Calmette Guerin) being a live attenuated vaccine may cause disseminated disease (BCGiosis) in patients with impaired immunity. Patients with severe combined immunodeficiency (SCID) having defection both cellular and humoral immunity are predisposed to a host of live vaccine related complications, especially BCG.

We report a 6 month-old baby boy with fever for 5 months, generalized rash for 3 months, cough and cold for 1 month, poor feeding and weight loss over last 1 month. He had an uneventful perinatal period and received BCG at birth. Examination revealed mild pallor, generalized erythematous papular rash with central crusting and splenohepatomegaly. Skin biopsy and culture confirmed BCG infection while computed tomography of abdomen and skeletal survey showed disseminated involvement. Immunological investigations were suggestive of an underlying SCID. The infant showed improvement with antitubercular therapy combined with intravenous immunoglobulin and other supportive measures.