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A 12-year-old boy presented with a slowly enlarging plaque, at the site of BCG vaccination (Statens Serum Institute, Danish strain 1331), administered 14 months previously (figure 1). Mantoux testing showed a 14 mm induration and his interferon-gamma (IFN-γ) release assay was negative. Skin biopsy revealed non-caseating dermal granulomata composed of epithelioid histiocytes and Langhans-type multinucleated giant cells (figure 2). No acid fast bacilli were seen. PCR for Mycobacterium tuberculosis complex (includes M bovis) was negative. Based on a clinical diagnosis …
This paper has been presented as an abstract for a poster presentation during the 34th Annual Meeting of the European Society of Paediatric Infectious Diseases held in Brighton, UK, from 10 to 14 May 2016.
Contributors DP, EPS and JXD were responsible for the care of the patient. RD and KD performed the IL-12–IFN-γ pathway and the genetic analysis. AB performed the histology examination and provided the histology images. The manuscript was written by EPS and DP and was reviewed by all coauthors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.