Bacillus Calmette-Guerin (BCG) has been used to vaccinate patients in regions with a high prevalence of tuberculosis. Its use may be associated with a range of adverse effects that range from minor to life-threatening.

BCG is a live vaccine.


Factors affecting the development of adverse effects (Murphy et al):

(1) dose and potency of the vaccine strain

(2) the route of delivery

(3) the age and immune status of the patient

(4) the skill of the person administering the vaccine


Adverse effects include:

(1) acute infection

(2) acute noninfectious reactions

(3) late effects


Acute infectious complications:

(1) localized at site of inoculation (ulceration, abscess)

(2) loco-regional lymphadenitis

(3) disseminated disease, typically in a patient with an immunodeficiency, including HIV


Acute noninfectious reactions:

(1) inflammation without infection at the inoculation site

(2) systemic constitutional symptoms (malaise, chills, sweating, flushing etc)

(3) change in heart and/or respiratory rate

(4) allergic reaction


Late effects:

(1) scarring at the inoculation site, including keloid formation

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