BCG Vaccine Induced Skin Eruption in a Child of 8 Months

Abstract:

BCG¹ (Bacillus-Calmette-Guerin) vaccine is considered the gold standard² for the prevention of tuberculosis. Many BCG vaccines are available worldwide, and all are derived from the original strain, but the vaccines vary in efficacy. BCG vaccines also show many adverse reactions such as skin eruption, injection site abscess and lymphadenitis^3, especially in infants.

The most common side effects of BCG vaccination are ulceration at the vaccination site and regional lymphadenitis.⁽⁵⁾ The local tissue response begins 2-3 weeks after vaccination, with scar formation and healing within three months. Many scars and eruptions take longer to heal.

In conventional treatment there is no perfect treatment for this condition. However, homoeopathy proves very effective in this condition and leads to permanent cure without any side effects.

Data-Collection:

This is a case documented from the OPD of CRU (Ranchi), CCRH. The case was treated successfully with the individualized homoeopathic medicine. Over a period of 6 months the patient showed remarkable improvement.

The case was selected from the OPD of the clinical research unit for homoeopathy, Ranchi.  The patient was contacted and photographs of the patient were taken at fixed intervals.

Case Presentation:

The patient, a male child, 8 months old, presented with BCG vaccine induced skin eruption on the left shoulder region. The eruption consisted of small multiple papular nodules with itching, that lasted for more than 6 months, without any recovery. The vaccine was given at birth.

Origin: The lesion started first as small papules which later became enlarged, causing pruritus, which later became enlarged causing distress to the infant.  There is no any other abnormality seen.

Morphology:  The eruption was small, multiple, papular nodules.

General examination:

Constitution: slender;

Complexion: dark

Height: 9 kg.

Weight:  68 cm.

Systemic examination:

No systemic disturbance.

Generals:

Appetite: decreased.                                                  Thirst: normal

Stool: normal                                                                 urine: normal

Perspiration: normal                                                    sleep: normal

Thermal:  Hot

Mentals:

The child was slow learning to talk & walk. Further, there was developmental delay after vaccination. There was no any other abnormality seen. Follow up of the patient was done periodically at fixed intervals as per protocol.

Synthesis repertory (radar 10.5 ),was referred  for repertorisation of the case . The following symptoms were considered for repertorisation.  The repertorisation chart (table1 ) is given below.

The prescription was Thuja, which on reportorial analysis scored highest (8 marks), covering 5 out of 5 symptoms. Thuja 30, prescribed 4gl. B.d for 1 month

BEFORE TREATMENT:

DURING TREATMENT: 1^st follow up (after 1 month)

2^nd follow up (after 3 months)

3^rd follow up

4^th Follow up

Conclusion:

Thuja 30 was selected after considering the mental generals, physical generals and particular symptoms of the patient. On reportorial analysis Thuja scored highest. Hence Thuja in 30c potency, was prescribed 4gl. B.d for 1 month and the case was again followed up. Closest to Thuja was Silicea, but Silicea is thermally chilly and the patient was thermally hot. There was progressive improvement in the condition of the patient, and the same medicine was continued until complete cure. This is a case, which speaks about the success of homoeopathy in the management of BCG induced skin eruption.

Bibliography :

1. Harrison principles of internal medicine 19^th edition.

Jameson,Anthony,S.Fauci,Dennis l.Kasper.

2. National study of adverse reaction after vaccination with Bacille-Calmette-Guerin.

F.M. Turnbull, P.B.Mclntyre, H.M. Achat, H.Wang.

3. Davidson’s prinples and practice of Medicine, 23^rd edition.

Stuart ralston , Ian penman, Mark Strachman.

4. A study of the incidence of BCG vaccine complications in infants of babol.(2011-13)

Rahim Barari-savadkouhi etal .

5. Complication following Bacille Calmette-Guerin Vaccination in Children under the age of 18 months : A multicentric study.

Roxana mansour Ghanaie etal .

6. Hutchinson’s Clinical Methods : An integrated approach to clinical practice. 23^rd edition.
7. Robins and cotrans pathologic basis of disease. 9^th editon.
8. Organon of medicine 5^th and 6^th edition. By Samuel Hahnemann. Translated by william boecicke. B.jain publishers.