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Free Content Osteitis caused by Bacille Calmette-Guérin vaccination: an emergent problem in Chile?

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Abstract:

SETTING: Osteitis caused by bacille Calmette-Guérin (BCGOST) vaccination has not been described in Latin American countries.

OBJECTIVE: To evaluate the incidence, clinical features and prognosis of patients with BCGOST in one of the most populated areas of Santiago, Chile.

DESIGN: A retrospective analysis of medical records kept over twenty years (1976–1995).

RESULTS: In ten children (four in the last five years), diagnostic criteria of BCGOST were fulfilled. Six were boys, the mean age was 11 months (range 6.5–21), symptoms were present with a mean of 31 days (range 15–60) before diagnosis and the sites of predilection of osteitis were the lower extremity (8/10 cases). Culture was positive in one case, and nine patients had typical histopathological lesions (two with acid-fast bacilli). All had normal chest X-ray. Mantoux testing was performed in four cases (mean 21.5 mm, range 16–28). None of the ten patients had a history of underlying immunodeficiency. In this area BCG coverage was 90.2 ± 9.7% of all newborn infants, and the annual risk of tuberculosis infection was 24.6/100000 population per year.

CONCLUSION: Our study demonstrated an estimated incidence for BCGOST in this area of 3.2/100000 vaccinated newborns. Based on the epidemiological situation of tuberculosis in Chile (29.5/100000), universal BCG vaccination in newborns should be encouraged.

Keywords: BCG vaccination; complication; osteitis

Document Type: Regular Paper

Affiliations: Exequiel González Cortés Children's Hospital, Pediatric Pulmonology Unit, Department of Pediatrics, University of Chile, Santiago, Chile

Publication date: October 1, 1997

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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