Disseminated bacille Calmette-Guerin disease after vaccination: Case report and review
Disseminated bacille Calmette-Guerin disease after vaccination: Case report and review
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DOI：
10.1086/513642
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发表时间：
1997-06-01
影响因子：
11.8
通讯作者：
Frothingham, R
中科院分区：
文献类型：
--
作者：
Talbot, EA;Perkins, MD;Frothingham, R
接种减毒卡介苗是为了预防结核病。接种疫苗的并发症并不常见。我们报告了一种新的传播性卡介苗疾病，并回顾了从1980年至1996年间发表的超过5，000份报告中发现的另外27例病例。在28例病例中，有24例与免疫缺陷有关，包括9例艾滋病病例。71%的病例发生在2岁以下的儿童中。68%的患者是男性。大约一半的患者在发达国家接种疫苗，但85%的病例来自发达国家。对治疗的反应很差，总死亡率为71%。我们提出了两个新的意见。播散性卡介苗病在历史上是一种婴儿疾病，但现在病例发生在成人和年龄较大的儿童合并感染人类免疫缺陷病毒。病例也发生在初次接种卡介苗后无反应性的个体再次接种疫苗后。播散性卡介苗病是一种罕见的，但毁灭性的并发症的疫苗接种，应考虑在适当的临床设置。免疫功能低下的婴儿和晚期艾滋病患者的风险最大，对标准疗法的反应很差。
The attenuated bacille Calmette Guerin (BCG) vaccine is administered to prevent tuberculosis. Complications of vaccination are uncommon. We report a new ease of disseminated BCG disease and review 27 additional cases identified from a review of >5,000 reports published between 1980 and 1996. Twenty-four of the 28 total cases were associated with an immune deficiency, including nine cases of AIDS. Seventy-one percent of the eases occurred in children younger than 2 years old. Sixty-eight percent of the patients were male. About one-half of the patients were vaccinated in a developed nation, but 85% of the cases were reported from a developed nation. Response to therapy was poor, with an overall mortality rate of 71%. We made two new observations. Disseminated BCG disease has historically been a disease of infants, but cases now occur in adults and older children coinfected with human immunodeficiency virus. Cases also occur after revaccination of individuals who were anergic following the initial administration of BCG vaccine. Disseminated BCG disease is an uncommon but devastating complication of vaccination that should be considered in the appropriate clinical setting. Immunocompromised infants and patients with late-stage AIDS are at greatest risk and respond poorly to standard therapies.