Clinical Analysis Of 58 Children With Bacillus Calmette-guerin Disease

Object : To study the clinical characteristics,Immunological characteristics,treatment and prognosis of Bacillus Calmette-Guérin(BCG)disease.Method:Retrospective analysis of the clinical data of 58 children with BCG disease seen from January 2015 to December 2019 in Children’s Hospital of Chongqing Medical University.Results: In the 58 cases,36(62.1%)patients were boys and 22(37.9%)patients were girls.1(1.7%)had local disease,45(77.5%)had regional disease,4(6.8%)had distant disease,and 8(13.8%)had disseminated disease.The affected tissues and organs were axillary lymph nodes ipsilateral to the vaccination site(n=55;94.8%),lung(n=9;15.5%),distant lymph nodes(n=6;10.3%),spleen(n=4;6.9%),liver(n=3;5.2%),subcutaneous tissue(n=3;5.2%),central nervous system(n=1;1.7%),bone(n=1;1.7%)and so on.Among these 46 children diagnosed with local/regional BCG disease,9(19.6%)patients had definitive primaryimmunodeficiency disease(PID),including 3 cases with chronic granulomatous disease(CGD),3 cases with severe combined immunodeficiency disease(SCID),1 case with mendelian susceptibility to mycobacterial disease(MSMD),1 case with hyper immunoglobulin M syndrome(HIGM),and 1 case with hyper immunoglobulin E syndrome(HIES).Among the 12 patients with distant/disseminated BCG disease,8(66.7%)children were diagnosed with PID:4 had CGD,4 had SCID.32 cases with local/regional infection had been followed up,for the prognosis22 cases were recovery,7 patients were improved and 3 patients were dead.9 patients with distant/disseminated infection had been followed up,for the prognosis 8 children survived and 1 patient was dead.Conclusions:Among hospitalized children,regional BCG disease is the most common type of BCG disease.The most frequently affected tissue/organ is the axillary lymph node on the same side of BCG vaccination,and the remote tissue/organ most frequently affected is lung.The happen of BCG disease is closely related to the immune function of children.CGD and SCID are the most common immune deficiency diseases in patients with BCG disease.