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Mycobacterium bovis Osteomyelitis as a Complication of Bacille Calmette-Guérin (BCG) Vaccination: Rapid Diagnosis with Use of DNA Sequencing Analysis. A Case Report*
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Investigation performed at National Cheng Kung University Medical College, Tainan
J Bone Joint Surg Am, 1999 Sep 01;81(9):1305-11
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Vaccination with bacille Calmette-Guérin (BCG) has been used for the prevention of tuberculosis in many areas of the world. It is estimated that more than three billion people worldwide have been vaccinated with live BCG since 19459. In almost all children, inoculation with BCG is harmless. However, it must be understood that BCG, like other vaccines, such as that for poliomyelitis and even that for measles, mumps, and rubella, occasionally produces adverse reactions5,11,21-23. Despite these rare complications, BCG has proved to be effective for preventing miliary tuberculosis and tubercular meningitis in many developing countries. Disseminated complications were observed in association with approximately one per million vaccinations, and severe local reactions occurred in approximately 2 percent of individuals who were vaccinated11,22,23. BCG osteomyelitis has been reported often in Europe but relatively rarely elsewhere1-3,6,7,13,25; however, it may not be as rare as it seems. It is possible that the diagnosis may be missed unless the treating physician has a high index of suspicion and unless a sensitive technique of identification is available. This complication deserves greater attention because it has been reported in association with intravesical administration of BCG for the treatment of carcinoma of the bladder8,24.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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