关键词: 播散性卡介苗病, 儿童, 血栓性微血管病, 死亡, 结核分枝杆菌

Abstract: Disseminated bacillus Calmette-Guérin (BCG) disease is a rare but serious BCG complication in children. Early diagnosis and timely interventions are essential to improve prognosis. However, its clinical manifestations are heterogeneous, which usually leads to a high misdiagnosis rate. We reported in this article a case of 5-month and 13-day-old male infant who was admitted to the hospital due to "generalized edema for 12 days accompanied by decreased urine output. Laboratory tests showed massive proteinuria, hypoalbuminemia, hemolytic anemia, thrombocytopenia and increased serum creatinine, which were consistent with the clinical features of thrombotic microangiopathy. Metagenomic sequencing of peripheral blood showed the Mycobacterium tuberculosis complex (MTC), and the sputum X-pert test confirmed the infection with rifampicin-resistant Mycobacterium bovis. Lung CT showed consolidation shadows and pleural effusion. Considering that the above-mentioned clinical symptoms and laboratory characteristics occurred shortly after BCG vaccination, the diagnosis of disseminated BCG disease was made. The infant received anti-tuberculosis treatment with isoniazid, ethambutol, moxifloxacin, etc., as well as plasma exchange and supportive treatment, but all were ineffective, and he eventually died of respiratory failure. This case is helpful for improving the understanding of disseminated BCG disease in children.

Key words: Disseminated Bacille Calmette-Guérin (BCG) disease, Children, Thrombotic microangiopathy, Death, Mycobacterium tuberculosis