Bacille Calmette-Guérin Vaccine-Induced Tuberculous Hip Osteomyelitis in an Infant : Case report

Abstract

To this day, tuberculosis (TB) continues to pose a significant global health burden. The World Health Organization’s Expanded Programme on Immunization (EPI) recommends the bacille Calmette-Guérin (BCG) vaccine for infants to protect against the haematogenous spread of primary TB and other more severe types of TB infection. We report an eight-month-old boy who presented to the Armed Forces Hospital, Muscat, Oman, in 2015 with a one-month history of intermittent fever associated with a limited range of motion in the right hip area. He was up-to-date with his EPI vaccinations and had no history of exposure to individuals with TB infections. He was initially treated for bacterial septic arthritis; however, a GeneXpert TB assay revealed the presence of Mycobacterium tuberculosis, BCG strain. To the best of the authors’ knowledge, this is the first documented case from Oman of a child with TB hip osteomyelitis due to a BCG vaccination.