Grange J M
Imperial College School of Medicine, University College London Medical School.
Commun Dis Public Health. 1998 Jun;1(2):84-8.
Complications of bacille Calmette-Guérin (BCG) vaccination are uncommon. Fewer than one in 1000 people vaccinated develop significant local reactions, and serious disseminated disease develops in fewer than one in a million. Localised complications--which include hypersensitivity reactions, abscesses at the injection site, and localised lymphadenopathy--are usually self limiting. They usually result from faulty technique, including the accidental intracutaneous injection of the stronger percutaneous vaccine, or poor selection of subjects for vaccination. Abscesses at the injection site usually respond to drainage and chemotherapy with isoniazid or erythromycin. Lymphadenopathy responds poorly to antimicrobial treatment and surgery may be needed for suppurating or discharging lesions to hasten recovery and give a good cosmetic result. Disseminated disease usually occurs in people with impaired immunity, in whom it is often fatal. BCG should never be given to people who are known to be infected with HIV, but the risk of complications in children born to HIV infected mothers is low. Disseminated disease can also result from intravesical instillation of BCG to treat bladder cancer, but this responds to antituberculosis chemotherapy.
卡介苗（BCG）接种的并发症并不常见。每1000名接种者中发生严重局部反应的不到1人，每100万人中发生严重播散性疾病的不到1人。局部并发症——包括过敏反应、注射部位脓肿和局部淋巴结病——通常为自限性。它们通常是由操作技术不当引起的，包括意外将更强效的皮内疫苗误注入皮下，或疫苗接种对象选择不当。注射部位脓肿通常通过引流以及使用异烟肼或红霉素进行化疗来治疗。淋巴结病对抗菌治疗反应不佳，对于化脓或有分泌物的病灶可能需要手术治疗，以加速康复并获得良好的美容效果。播散性疾病通常发生在免疫力受损的人群中，往往是致命的。已知感染HIV的人绝不应接种卡介苗，但感染HIV的母亲所生儿童发生并发症的风险较低。膀胱内灌注卡介苗治疗膀胱癌也可能导致播散性疾病，但这种情况对抗结核化疗有反应。
