Granulomatous hepatitis as a rare complication of Bacillus Calmette-Guerin vaccination

Abstract

Bacillus Calmette-Guerin (BCG) vaccine, which is a widely practiced vaccine in some regions, could lead to a variety of complications. Herein, a 2-month-old infant is presented who was referred because of hepatosplenomegaly and diarrhea. Liver biopsy indicated multiple small and large granulomas composed of epithelioid histiocytes; granulomas resided in portal or lobular areas. The diagnosis of granulomatous hepatitis was made, and treatment with isoniazid, rifampine, and ethambutol were started. Liver function tests were normalized and hepatosplenomegaly was reduced in an 8-month follow-up. The presence of epithelioid cell granuloma in the liver may indicate a diagnosis of disseminated BCG as a rare complication of vaccination. Prompt diagnosis and appropriate treatment could prevent further complications in the affected patients.