Post-vaccination Tubercular Cold Abscess of Thigh of An Infant

Öz

We report a case of post immunization tubercular soft tissue cold abscess on a lateral part of the right thigh in an eight-month-old male baby following third dose of intramuscular Hepatitis B vaccination. The baby presented with gradual onset of fever for 10 days after hepatitis B vaccination this was followed by an erythematous, painless, firm small swelling on the anterolateral part of the right thigh which grew gradually to a size of 2 × 2.5 cm size. The baby was treated with empirical antibiotics (Amoxicillin) following which fever subsided but there was no improvement in swelling so the baby was advised for various laboratory investigations. The aspirate from the abscess was subjected to Acid fast staining using microscopy (Ziehl-Neelsen staining) that revealed Acid Fast Bacilli (2+). In addition (Cartridge Based Nucleic Acid Amplification Test) confirmed the presence of M. tuberculosis complex sensitive to Rifampicin. J Microbiol Infect Dis 2020; 10(4): 234-236.

Anahtar Kelimeler

• M. tuberculosis complex
• CB-NAAT
• Abscess
• Acid-fast bacilli

Kaynakça

1. 1. Gupta P, Menon PSN, Ramji S, et al. PG Textbook of Pediatrics: Infections and Systemic Disorders; 2018;2:1139-1147.
2. 2. Mishra D, Mohta A, Arora P. Cold abscess of the thigh in an infant. Kathmandu Univ Med J. 2013; 41:86-87.
3. 3. Agrawal A, Jain A. Tuberculosis Cold Abscess. Indian J Pediatr 2007; 74:771-773.
4. 4. Gondal KM, Iqbal Y, Khan UA, et al. Frequency of Contributing Factorsin Intramuscular Injection Abscess. PJMHS 2014; 569-572.
5. 5. Tan NWH, Pan WJ, Yunos HBM, et al. Postvaccination abscesses requiring surgical drainage in a tertiary childrens hospital in Singapore. J Pediatr Infect Dis 2010; 5:139-147.
6. 6. Dixit R, Dixit K, Patil CB, et al. Injection site abscess due to Mycobacteriology tuberculosis following DPT vaccinations. Indian J Tuberc 2014; 61:246-249.
7. 7. Namshan M, Oda O, Zamakhshary M, et al. Bacillus Calmette Guerin related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series. J Med Case Reports 2011; 5:472.
8. 8. Verma S, Didel S. Cold abscess of thigh following inadvertent vaccination in an infant; Indian J Child Health 2016;3:76-78.

9. 9. Shah A, Dash B. Primary Tubercular Abscess of Thigh in Infancy. Indian Pediatr 2015; 52:992.
10. 10 Sharma J, Sharma T, Bhatt GC, et al. Isolated cold abscess of the thigh in an immunocompetent infant. Trop Doct 2014; 44:221-222.