Chemotherapeutically induced cutaneous tuberculosis after BCG injection in a patient with pelvic osteosarcoma

Surg Infect (Larchmt). 2012 Dec;13(6):406-8. doi: 10.1089/sur.2011.117. Epub 2012 Dec 16.

Abstract

Background: Tuberculosis (TB) is a serious infection afflicting a multitude of people worldwide. Recently, its prevalence has increased. The incidence of skin involvement generally is low. Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that typically is administered as a vaccine to stimulate the immune system when treating some early neoplasms or to guard against tuberculosis.

Methods: Case report and literature review.

Case report: The authors describe a young man with osteosarcoma of the left hemipelvis who received intradermal BCG injection for immune stimulation prior to surgery. In the course of neoadjuvant chemotherapy, he developed cutaneous tuberculosis.

Conclusion: It is our opinion that BCG injection should be avoided in all patients requiring surgery, especially in oncologic patients, where the immunodeficiency brought on by chemotherapy predisposes to active opportunistic infection.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • BCG Vaccine / administration & dosage
  • BCG Vaccine / adverse effects*
  • BCG Vaccine / immunology
  • Bone Neoplasms / immunology
  • Bone Neoplasms / therapy*
  • Humans
  • Male
  • Mycobacterium bovis / immunology*
  • Neoadjuvant Therapy / methods
  • Osteosarcoma / immunology
  • Osteosarcoma / therapy*
  • Pelvic Neoplasms / immunology
  • Pelvic Neoplasms / therapy*
  • Tuberculosis Vaccines / administration & dosage
  • Tuberculosis Vaccines / adverse effects*
  • Tuberculosis, Cutaneous / etiology
  • Tuberculosis, Cutaneous / immunology*

Substances

  • BCG Vaccine
  • Tuberculosis Vaccines