Lymphadenitis caused by infection with an isoniazid- and rifampin-resistant strain of Mycobacterium bovis BCG in an infant with IFN-γ/IL-12 pathway defect

We report a rare case in a female infant (age, 3.5 months) with primary immunodeficiency (IFN-γ/IL-12 pathway defect) who presented with suppurative lymphadenitis after Mycobacterium bovis BCG vaccination. The strain of M. bovis BCG identified was found to be resistant to isoniazid and rifampin. The...

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Bibliographic Details
Published in:Jornal brasileiro de pneumologia 2014-04, Vol.40 (2), p.188-192
Main Authors: Diniz, Lilian Martins Oliveira, Guimarães, Tiago, Oliveira, Maria das Graças Rodrigues de, Pinto, Jorge Andrade, Miranda, Silvana Spindola de
Format: Article
Language:eng ; por
Subjects:
Antitubercular Agents - pharmacology
BCG Vaccine - adverse effects
Case Report
Drug Resistance, Bacterial
Female
Humans
Immunologic Deficiency Syndromes - immunology
Infant
Interferon gama
Interferon-gamma - metabolism
Interleukin-12 - metabolism
Isoniazid - pharmacology
Lymphadenitis - microbiology
Mycobacterium bovis - drug effects
RESPIRATORY SYSTEM
Rifampin - pharmacology
Tuberculose resistente a múltiplos medicamentos
Vacina BCG
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Summary:We report a rare case in a female infant (age, 3.5 months) with primary immunodeficiency (IFN-γ/IL-12 pathway defect) who presented with suppurative lymphadenitis after Mycobacterium bovis BCG vaccination. The strain of M. bovis BCG identified was found to be resistant to isoniazid and rifampin. The patient was treated with a special pharmacological regimen involving isoniazid (in a limited, strategic manner), ethambutol, streptomycin, and IFN-γ, after which there was complete resolution of the lesions.
ISSN:1806-3713
1806-3756
1806-3756
1806-3713
DOI:10.1590/S1806-37132014000200014