Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.
Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
BMJ Case Rep. 2024 Sep 10;17(9):e261058. doi: 10.1136/bcr-2024-261058.
The BCG vaccine is considered a safe and efficacious vaccine in the prevention of severe forms of tuberculosis. BCG osteomyelitis is a rare complication of the BCG vaccine that occurs in vaccinated young children. We report a case of BCG osteomyelitis in a male toddler, presenting with painful left wrist swelling without preceding fever or systemic symptoms. Radiographic evidence of osteomyelitis in the left wrist was observed. Initial treatment with conventional antibiotics for acute haematogenous osteomyelitis showed no improvement. The diagnosis of BCG osteomyelitis was confirmed via tissue samples for histopathological examination and mycobacterial cultures. The patient responded well to treatment with oral antituberculous therapy. This case highlights the importance of considering BCG osteomyelitis in the differential diagnosis of unexplained joint swelling in BCG-vaccinated young children.
卡介苗被认为是预防严重结核病的一种安全有效的疫苗。BCG 骨髓炎是卡介苗疫苗的一种罕见并发症,发生于接种卡介苗的幼儿。我们报告了一例男性幼儿的 BCG 骨髓炎病例,表现为左侧腕关节肿胀伴疼痛,无发热或全身症状。观察到左侧腕关节骨髓炎的放射学证据。最初使用常规抗生素治疗急性血源性骨髓炎没有改善。通过组织样本进行组织病理学检查和分枝杆菌培养,确诊为 BCG 骨髓炎。患者对口服抗结核治疗反应良好。本病例强调了在卡介苗接种的幼儿中,对不明原因关节肿胀进行鉴别诊断时,考虑 BCG 骨髓炎的重要性。