Mycobacterial disease in patients with chronic granulomatous disease: A retrospective analysis of 71 cases.
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Conti Francesca, Lugo-Reyes Saul Oswaldo, Blancas Galicia Lizbeth, He Jianxin, Aksu Güzide, Borges de Oliveira Edgar, Deswarte Caroline, Hubeau Marjorie, Karaca Neslihan, de Suremain Maylis, Guérin Antoine, Baba Laila Ait, Prando Carolina, Guerrero Gloria G, Emiroglu Melike, Öz Fatma Nur, Yamazaki Nakashimada Marco Antonio, Gonzalez Serrano Edith, Espinosa Sara, Barlan Isil, Pérez Nestor, Regairaz Lorena, Guidos Morales Héctor Eduardo, Bezrodnik Liliana, Di Giovanni Daniela, Dbaibo Ghassan, Ailal Fatima, Galicchio Miguel, Oleastro Matias, Chemli Jalel, Danielian Silvia, Perez Laura, Ortega Maria Claudia, Soto Lavin Susana, Hertecant Joseph, Anal Ozden, Kechout Nadia, Al-Idrissi Eman, ElGhazali Gehad, Bondarenko Anastasia, Chernyshova Liudmyla, Ciznar Peter, Herbigneaux Rose-Marie, Diabate Aminata, Ndaga Stéphanie, Konte Barik, Czarna Ambre, Migaud Mélanie, Pedraza-Sánchez Sigifredo, Zaidi Mussaret Bano, Vogt Guillaume, Blanche Stéphane, Benmustapha Imen, Mansouri Davood, Abel Laurent, Boisson-Dupuis Stéphanie, Mahlaoui Nizar, Bousfiha Ahmed Aziz, Picard Capucine, Barbouche Ridha, Al-Muhsen Saleh, Espinosa-Rosales Francisco J, Kütükçüler Necil, Condino-Neto Antonio, Casanova Jean-Laurent, Bustamante Jacinta
Аннотация
OBJECTIVE: Our objective was to assess the effect of mycobacterial disease in patients with CGD.
METHODS: We analyzed retrospectively the clinical features of mycobacterial disease in 71 patients with CGD. Tuberculosis and BCG disease were diagnosed on the basis of microbiological, pathological, and/or clinical criteria.
RESULTS: Thirty-one (44%) patients had tuberculosis, and 53 (75%) presented with adverse effects of BCG vaccination; 13 (18%) had both tuberculosis and BCG infections. None of these patients displayed clinical disease caused by environmental mycobacteria, Mycobacterium leprae, or Mycobacterium ulcerans. Most patients (76%) also had other pyogenic and fungal infections, but 24% presented solely with mycobacterial disease. Most patients presented a single localized episode of mycobacterial disease (37%), but recurrence (18%), disseminated disease (27%), and even death (18%) were also observed. One common feature in these patients was an early age at presentation for BCG disease. Mycobacterial disease was the first clinical manifestation of CGD in 60% of these patients.
CONCLUSION: Mycobacterial disease is relatively common in patients with CGD living in countries in which tuberculosis is endemic, BCG vaccine is mandatory, or both. Adverse reactions to BCG and severe forms of tuberculosis should lead to a suspicion of CGD. BCG vaccine is contraindicated in patients with CGD.