Bacille Calmette-Guérin osteomyelitis of the proximal femur

Abstract

All newborns in Hong Kong are given bacille Calmette-Guérin vaccinations. Reported complications include formation of regional and extra-regional localised abscesses, osteomyelitis, and lymphadenitis. Several cases of bacille Calmette-Guérin osteomyelitis have been reported in Europe, but there are few reports of this in Asia. To the author's knowledge, this is the first case report of bacille Calmette-Guérin osteomyelitis in Hong Kong. Bacille Calmette-Guérin osteomyelitis, although rare, should be kept in mind as a potential complication of bacille Calmette-Guérin vaccination. Clinical suspicion, early diagnosis using an image-guided tissue biopsy and polymerase chain reaction study, and early commencement of chemotherapy are key to the effective management of this problem.

所有在香港的初生嬰兒都會接種卡介苗，曾有報告指出不良反應包括在接種位置及其他位置出現局部性膿腫、骨髓炎和淋巴結發炎。歐洲曾有數宗因接種卡介苗而引發骨髓炎的病例，但亞洲很少有類似病例。據我們所知，本報告為香港首宗卡介苗骨髓炎病例，雖然非常罕見，但必須緊記此病可以是卡介苗的一種併發。要有效處理此病，最重要是有高度警覺性、透過圖像引導的組織切片及聚合酶鏈反應得到早期診斷、以及為病人盡早施行化療。