[CIS PIDD] CGD-tuberculosis

[Sergio Rosenzweig]

Hi Safa,
We didn't use mycobacteria prophylaxis at our center in Buenos Aires (50
CGD pts until 2009, almost all of them BCG vaccinated within 48h of
life, high TB endemicity country, no TB cases in the cohort).  CGD pts
are certainly more susceptible to TB, as shown in other high endemicity
areas  (Ped Infect Dis J 2008, 27:224-230; Clinical Infectious Diseases
1998;26:226–7), and even in the US, 4% of pneumonias in CGD are due to
mycobacterias (Medicine 2000, 79:155-69), but in our experience more
prevalent and complex than TB, was the BCG isssue: when we apply  30,000
to 3,200,000  live mycobacteria intradermally to a CGD neonate. In our
experience, localized regional BCG-itis was a problem, but was usually
medically/surgically manageable. However, different countries with
different BCG  strains have more frequent and severe complications (eg
Brazil, Rio strain, disseminated BCGosis). 
The prospect of adding antimycobacterial prophylaxis (weekly
azythromicin?) in a high endemicity/TB prevalence enviroment sounds
reasonable. 
Sergio


Sergio D. Rosenzweig, MD, PhD
Chief, Infectious Diseases Susceptibility Unit
Laboratory of Host Defenses, NIAID, NIH
10 Center Dr., Bldg. 10, CRC 5W-3888
Bethesda, MD 20892-1456
Phone (301) 451 8971
Fax (301) 451 7901
Cell (240) 361 7617
Pager 102 10678
srosenzweig at niaid.nih.gov
 
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>>> Safa baris  06/07/12 12:50 PM >>>

<!--.hmmessage P{margin:0px;padding:0px}body.hmmessage{font-size:
10pt;font-family:Tahoma}-->Dear Immunology interesting group;
 
We recently mange 2 X-linked CGD patientswith M.tuberculosis infections.
Inour country the BCG vaccination perform routinely to all infants at 1
mo ofage. So my question about use of prophylaxis of anti-tbc drugs for
CGDpatients. Does anyone have experience with this issue?
 
Thanks.
 
Safa BARIS, MD
Marmara University, Division ofPediatric Allergy and Immunology
ISTANBUL/TURKEY 
       

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