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BCG Infection due to MPT64-Negative Strain: A Diagnostic Challenge.

Publication Type : Journal Article

Thematic Areas : Nanosciences and Molecular Medicine

Publisher : The American Journal of Tropical Medicine and Hygeine

Source : Am J Trop Med Hyg, Volume 103, Issue 3, p.1072-1075 (2020)

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Keywords : BCG vaccine, female, Humans, infant, male, Mycobacterium bovis, Mycobacterium tuberculosis, Nontuberculous Mycobacteria, Tuberculosis

Campus : Kochi

School : Center for Nanosciences

Center : Nanosciences

Department : Nanosciences and Molecular Medicine

Year : 2020

Abstract : MPT64 is a 24-kDa immunogenic protein that is widely used as a diagnostic marker for the differentiation of complex (MTBC) from nontuberculous (NTM). Unlike , Bacillus Calmette-Guerin (BCG) vaccine strains with RD2 deletion do not secrete MPT64. Culture isolates from infections due to these strains may be falsely identified as nontuberculous in the absence of clinical correlation. Here, we present one case each of BCG adenitis and osteitis, both of which were considered as MPT64 card-negative spp. (i.e., NTM) and were later identified as BCG Danish 1331 strain. The first case was a 4-month-old female infant admitted with swollen lymph nodes in the left supraclavicular and the left axillary region of 1 month duration. The second case was of a 1-year-and-5-month-old male child who presented with a limp on the left leg and soft tissue swelling of 1 month duration on the anterolateral aspect of the left knee joint. In both cases, BCG vaccine was administered at birth on the left deltoid region and had healed without any complication. Clinical samples in both cases were positive by Xpert tuberculosis/RIF for MTBC, and cultures grew acid-fast bacilli which were negative by MPT64 assay. The clinical implication of infections due to BCG is immense as they are inherently resistant to pyrazinamide, and the presence of disseminated BCG infection in young children is a hallmark of serious immune deficiency which needs to be ruled out.

Cite this Research Publication : Parasmal Suresh, Lalitha Biswas, Prasad, V., Anil Kumar, Sivadas, S., Khan, S., and Dr. Raja Biswas, “BCG Infection due to MPT64-Negative Strain: A Diagnostic Challenge.”, The American Journal of Tropical Medicine and Hygeine, 2020 Sep 103(3):1072-1075

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