دورية أكاديمية
Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series
| العنوان: | Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series |
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| المؤلفون: | Seyed Alireza Mahdaviani, Mazdak Fallahi, Mahnaz Jamee, Majid Marjani, Payam Tabarsi, Afshin Moniri, Parisa Farnia, Zahra Daneshmandi, Nima Parvaneh, Jean-Laurent Casanova, Jacinta Bustamante, Davood Mansouri, Ali Akbar Velayati |
| المصدر: | Annals of Clinical Microbiology and Antimicrobials, Vol 21, Iss 1, Pp 1-9 (2022) |
| بيانات النشر: | BMC, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Therapeutics. Pharmacology LCC:Infectious and parasitic diseases LCC:Microbiology |
| مصطلحات موضوعية: | MSMD, BCG-osis, IFN-γ, Anti-mycobacterial agents, Inborn error of immunity, Therapeutics. Pharmacology, RM1-950, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502 |
| الوصف: | Abstract Background Post-vaccination BCG disease typically attests to underlying inborn errors of immunity (IEIs), with the highest rates of complications in patients with Mendelian susceptibility to mycobacterial disease (MSMD). However, therapeutic protocols for the management of BCG-osis (disseminated) and persistent BCG-itis (localized) are still controversial. Methods Twenty-four Iranian patients with MSMD (BCG-osis or BCG-itis), followed from 2009 to 2020 in Tehran, were included in the study. Their medical records were retrospectively reviewed for demographics, clinical features, laboratory findings, and molecular diagnosis. The therapeutic protocol sheets were prepared to contain the types and duration of anti-mycobacterial agents. Results BCG disease either as BCG-itis (33.3%) or BCG-osis (66.7%) was confirmed in all patients by positive gastric washing test (54.2%), microbial smear and culture (58.3%), or purified protein derivative (PPD) test (4.2%). The duration between BCG-osis onset and MSMD diagnosis was 21.6 months. All except three patients were initiated on second-line anti-mycobacterial agents with either a fluoroquinolone (levofloxacin: 15 mg/kg/day, ciprofloxacin: 20 mg/kg/day, ofloxacin: 15 mg/kg/day), aminoglycoside (amikacin: 10–15 mg/kg/day, streptomycin: 15 mg/kg/day), and/or macrolide (clarithromycin: 15 mg/kg/day) along with oral rifampin (10 mg/kg/day), isoniazid (15 mg/kg/day), and ethambutol (20 mg/kg/day). Three patients showed a clinical response to rifampin, despite in vitro resistance. Fourteen (58.3%) patients received also adjuvant subcutaneous IFN-γ therapy, 50 µ/m2 every other day. At the end of survey, most patients (n = 22, 91.7%) were alive and two patients died following BCG-osis and respiratory failure. Conclusions We recommend the early instigation of second-line anti-mycobacterial agents in MSMD patients with BCG disease. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1476-0711 |
| Relation: | https://doaj.org/toc/1476-0711 |
| DOI: | 10.1186/s12941-022-00500-y |
| URL الوصول: | https://doaj.org/article/e7a6018243a24138a3a97bb5a3c314e8 |
| رقم الأكسشن: | edsdoj.7a6018243a24138a3a97bb5a3c314e8 |
| قاعدة البيانات: | Directory of Open Access Journals |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 14760711 |
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| DOI: | 10.1186/s12941-022-00500-y |