The BCG ( Bacillus Calmette-Guérin) vaccine is effective in preventing early-life infections with Mycobacterium Tuberculosis. The WHO recommends BCG vaccination as soon as posible after birth for all infants in high-burden countries. All Iranian newborns received BCG vaccine immediately after birth. Although BCG vaccine is safe, but some complications may occur especially in immune-compromised infants. Disseminated BCG disease, also called BCGosis, is a rare but life-threatening complication.Here we present a young infant with recurrent vomiting due to gastric outlet obstruction.
A 12 month-old infant boy was admitted in our tertiary children hospital due to severe failure to thrive and recurrent vomiting. After through investigations, we performed upper gastrointestinal series and an external pressure effect was detected on C-loop of duodenum. After resuscitation with fluids, patient was candidate for surgery and underwent emergent laparotomy. There was severe inflammation of small intestine mesentery and too many prominent lymphadenopathy and fibrosis of mesentery and retro-peritoneum. Some fibrotic bands attached to jejunum. These pathologies result in complete obstruction of small intestine at proximal of jejunum.
The pathology report shows severe histiocytic infiltration of lymph nodes and was positive for numerous acid fast bacilli.
Although very rare, but we should consider anatomical bowel obstruction due to external pressure effect in patients with BCGosis