[CIS PIDD] CGD-tuberculosis

[Safa baris]

Thanks alot 


Safa BARIS, MD

Marmara University, Division of
Pediatric Allergy and Immunology

ISTANBUL/TURKEY 
Date: Thu, 7 Jun 2012 14:35:27 -0400
From: srosenzweig at garrahan.gov.ar
To: pagid at list.clinimmsoc.org
Subject: Re: [CIS PIDD] CGD-tuberculosis

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 >>>








Dear Immunology interesting group;

 

We recently mange 2 X-linked CGD patients
with M.tuberculosis infections. In
our country the BCG vaccination perform routinely to all infants at 1 mo of
age. So my question about use of prophylaxis of anti-tbc drugs for CGD
patients. Does anyone have experience with this issue?

 

Thanks.

 

Safa BARIS, MD

Marmara University, Division of
Pediatric Allergy and Immunology

ISTANBUL/TURKEY 

 		 	   		   		 	   		  
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