Bacillus Calmette-Guerin Vaccine-Induced Lupus Vulgaris in a Child With Trisomy 9

Abstract

Introduction: Lupus vulgaris (LV) is one type of cutaneous Tuberculosis (TB) but a rare complication of (BCG) vaccination. Case Presentation: We report a 13-month-old boy with trisomy 9 who developed LV on his right arm with extension to anterior part of the chest one month after BCG vaccination. Culture and Gram stain was negative for mycobacteria. The diagnosis was confirmed by clinical and histopathological correlation and eventually Mycobacterium bovis was detected in tissues using the Polymerase Chain Reaction (PCR) method. The patient was treated with isoniazid, rifampin and ethambutol. Two months after drug therapy, marked improvement was developed. Conclusions: Post immunization LV is a rare complication of the BCG vaccine and should be considered by any physician. Lupus vulgaris is a paucibacillary form of TB. Therefore, acid fast bacilli are not detected in most cases. The PCR is a useful method for confirmation of the diagnosis of LV.