Arch Hand Microsurg.  2020 Jun;25(2):134-139. 10.12790/ahm.20.0017.

Bacille Calmette-Guérin Osteomyelitis of the Distal Radius in a Toddler

• Kim JY
• Jeon JI
• Chang H

• KMID: 2502710
• DOI: http://doi.org/10.12790/ahm.20.0017

Abstract

BCG (Bacille Calmette-Guérin) vaccine has been administered safely to billions of people all over the world. The Tokyo-172 strain has reported to have a lower virulence and side effects than other strains. BCG osteomyelitis of distal radius is a very rare but serious complication due to generalized dissemination of BCG. We report a rare case of BCG osteomyelitis of the distal radius in a 21-month-old girl who had no underlying disorders. Although uncommon, BCG osteomyelitis should be considered a possible complication of BCG vaccination under certain clinical features for early diagnosis and proper treatment.

Keyword

BCG vaccine; Osteomyelitis; Toddler

Figure

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  Fig. 1. Preoperative photograph on radial aspect of the left wrist. About 2 x 1 cm sized ulcerative lesion involving subcutaneous layer.

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  Fig. 2. The wrist X-ray image taken at the time of suspicion of osteomyelitis shows a well-defined metaphyseal lytic lesion with geographic pattern. (A) Left image, anteroposterior view, (B) right image, lateral view.

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  Fig. 3. The wrist magnetic resonance image showing an aggressive lesion of the left distal radius combined with growth plate involvement and cortical disruption. (A) Left image, coronal view, (B) right image, axial view.

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  Fig. 4. Four-month follow-up wrist X-ray with disappearance of the lytic lesion. (A) Left image, anteroposterior view, (B) right image, lateral view.

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