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BCGitis and BCGosis in children with primary immunodeficiency — imaging characteristics

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Abstract

Background

When administered to an immune-compromised patient, BCG (Bacille Calmette-Guérin) can cause disseminated and life-threatening infections.

Objective

To describe the imaging findings in children with primary immunodeficiency and BCG-related infections.

Materials and methods

We reviewed the imaging findings of children with primary immunodeficiency treated at a children’s hospital during 2012–2014 with localized or disseminated BCG infection. Imaging modalities included US, CT and radiography.

Results

Nine children with primary immunodeficiency had clinical signs of post-vaccination BCGitis; seven of these children showed disseminated disease and two showed only regional lesions with characteristic ipsilateral lymphadenopathy. Overall, lymphadenopathy was the most prevalent feature (n = 8) and characteristically appeared as a ring-enhancing hypodense (CT) or hypoechoic (US) lesion. Visceral involvement with multiple abscesses appeared in the spleen (n = 2), liver (n = 1) and bones (n = 1). All lesions regressed following appropriate anti-tuberculosis treatment.

Conclusion

BCG infection needs to be considered in children with typical findings and with suspected primary immunodeficiency.

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Conflicts of interest

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, 2 Sheba Road, Ramat-Gan, 52621, Israel

    Shai Shrot, Aviva Ben-Shlush & Michalle Soudack

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Shai Shrot & Michalle Soudack

  3. Pediatric Infectious Diseases Unit, Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Israel

    Galia Barkai

Authors
  1. Shai Shrot
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  2. Galia Barkai
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  3. Aviva Ben-Shlush
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  4. Michalle Soudack
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Correspondence to Shai Shrot.

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Shrot, S., Barkai, G., Ben-Shlush, A. et al. BCGitis and BCGosis in children with primary immunodeficiency — imaging characteristics. Pediatr Radiol 46, 237–245 (2016). https://doi.org/10.1007/s00247-015-3464-z

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  • DOI: https://doi.org/10.1007/s00247-015-3464-z

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