FATAL BCG INFECTION IN AN IMMUNOCOMPETENT GIRL

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Abstract
A 6 yr old girl developed progressive symptons of increased intracranial pressure starting 5 mo. after BCG vaccination. At 13 mo. later craniotomy revealed an epithelioid cell granuloma of the arachnoid occluding the foramen of Magendie. No tubercle bacilli were found on histological examination. Insertion of a Pudenz shunt relieved the symptons. By 6 mo. later generalized BCG infection developed, and in spite of treatment with ethambutol, rifampicin and isoniazid for 10 wk, death occurred during an episode of increased intracranial pressure. Mycobacterium BCG could be cultured from several organs. The patient showed no obvious evidence of immunodeficiency as judged on the basis of previous disease history, particle concentration of granulocytes, B [bone marrow derived] and T [thymus derived] lymphocytes in peripheral blood, concentration of immunoglobulins in serum, response of lymphocytes to transformation with mitogens and antigens and histological findings in the thymus and BCG granulomas.