1 – Centro Hospitalar Lisboa Central
2 – Laboratório de Patologia Clínica
3 – Secção de Microbiologia
- Artigo em revista científica
BCG vaccination in Portugal of the National Immunization Program for all neonates, excepto in some specific situations. BCG vaccine is a live attenuated vaccine derived from Mycobacterium bovis, Bacille Calmette-Guérin, intrinsically resistant to Pyrazinamide. In Portugal the only authorized is the BCG Denmark strain 1331with a MIC of 0.4 mg/l MIC for Isoniazid, considered to be of Intermediate Susceptibility, as documented by the manufacturer (Statens Serum Institute).
Complications following BCG vaccination are rare and not severe most of the time. However, in individuals with primary or acquired immuno deficiency, the risk of local adverse reactions rises, as well as extra-regional and even disseminated BCGitis, extremely rare and with a high mortality rate. It is highly recommended in these situations the use of multiple antituberculous drugs.
We presente two BCGitis cases in children (lymphadenitis and disseminated BCGitis), with isolation of BCG strains resistant both to Isoniazid (low level) and Pyrazinamide in Laboratório de Microbiologia, CHLC.
The authors highlight the use in Portugal of a low-level Isoniazid resistant BCG vaccine, a fact that should be taken into account when selecting empirical antituberculous treatment for BCG complications.
Plavras Chave: BCG Vaccine; BCGitis, Low-level Isoniazid resistance