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Reactivation at BCG Vaccination Site in a Case of Multisystem Inflammatory Syndrome in Children

Praveen Unki, Assistant Professor, Department of Pediatrics, Topiwala National Medical College, Mumbai-400008, Karnataka, India. , Praveen Unki , Sujay Rangaswamy , Sri Raksha Satya , Shreyas Vishwanath

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Pediatric Education and Research 11(1):p 27-31, January – April 2023. | DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.11123.4

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Praveen Unki, Sujay Rangaswamy, Sri Raksha Satya, et al./Reactivation at BCG Vaccination Site in a Case of Multisystem Inflammatory Syndrome in Children/Pediatr Edu Res. 2023;11(1): 27-31.

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Abstract

Background: Kawasaki disease is a well known entity in pediatric age group and so is its counterpart Multisystem Inflammatory Syndrome in Children (MIS-C). MIS-C term became more popular during covid era as the infection started to affect pediatric age group. Now, a large number pediatricians have seencases of MIS-C. Reactivation of BCG scar is less commonly seen in Kawasaki disease and rare to never in a case of MIS-C. Case Presentation: We report a 6-month-old male child who presented with cold and fever. Covid Rapid Antigen Test (RAT) and Covid RTPCR were negative. He continued to have high grade feverwhich is unusual for a case of bronchiolitis and started on antibiotics. Clinical suspicion of MIS-C made and started to work up for the same. Examination revealed reactivation at BCG site with pealing of skin. Further investigations showed elevated CRP and d-dimer with positive anti-SARS COV2 antibody. Diagnosis of MIS-C confirmed and treated with methylprednisolone and IVIG. Conclusion: Reactivation at BCG site is well known entity in Kawasaki disease and as a post vaccination immune cross reactivity. But never reported in a case of MIS-C as less known abouthuman immunological response towards Covid-19 infection and its sequel. It can be considered as an early diagnostic tool in resource poor settings and at community level.

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Praveen Unki, Sujay Rangaswamy, Sri Raksha Satya, et al./Reactivation at BCG Vaccination Site in a Case of Multisystem Inflammatory Syndrome in Children/Pediatr Edu Res. 2023;11(1): 27-31.

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DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.11123.4

Keywords

Multisystem Inflammatory Syndrome in Children; BCG scar; IVIG; Methylprednisolone.

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