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Cutaneous Complications of BCG Vaccination in Infants with Immune Disorders: Two Cases and a Review of the Literature
Authors:Richard J Antaya   MD  † Erin S Gardner   MD  ‡ Miriam S Bettencourt   MD  ‡ Mike Daines   MD  §  Yamo Denise   MD  § Suwanee Uthaisangsook   MD  § Rebecca H Buckley   MD  § and Neil S Prose   MD  
Institution:Departments of Dermatology and Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA. richard.antaya@yale.edu
Abstract:Two infants, one with a T-cell-signaling defect resulting in a primary immunodeficiency syndrome and the other with severe combined immunodeficiency (SCID), are described. Both infants developed cutaneous infections secondary to their bacillus Calmette-Guérin (BCG) vaccinations. Both patients were from countries where BCG is routinely administered in infancy. The infant with the T-cell-signaling defect developed a disseminated infection involving the skin, while the infant with SCID developed a localized cutaneous infection at the site of his BCG immunization. These two cases resemble other reported cases of cutaneous BCG infection following routine vaccination in immunocompromised patients. Mycobacterium bovis infection should be considered in patients with cutaneous eruptions who have received BCG vaccination, especially those who are immunocompromised.
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