Disseminated BCG infection revealing a severe combined immunodeficiency: A case report


Hajer Ben Belgacem
Jihene Bouguila
Amel Tej
Samia Tilouche
Raoudha Kebaili
Najoua Kahloul
Mohamed Ridha Barbouche
Nejla Soyah
Lamia Boughammoura


Introduction: Bacillus Calmette Guerin (BCG) vaccine, which is administered to all newborns in Tunisia, can lead to serious complications
ranging from local disease to disseminated disease in a group of patients with primary immunodeficiency diseases.

Case report: A 3-month-old boy presented with persistent fever, hepato-splenomegaly and multiple osteolytic lesions. He was diagnosed
with severe combined immunodeficiency disease and disseminated BCG infection. Despite anti-tubercular therapy combined with intravenous
immunoglobulin, the evolution was fatal.

Conclusion: The case highlights the possible risk of such rare yet lethal complication of BCG vaccine. In suspected cases of primary immunodeficiency disease, inoculation of BCG should be postponed until appropriate screening tests exclude such diagnosis to prevent serious


Primary immunodeficiency, Mycobacterium Bovis, BCG vaccine



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