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Idiopathic disseminated bacillus Calmette–Guerin infection in three infants

We describe the cases of three infants between 4 and 9 months of age with disseminated bacillus Calmette–Guerin (BCG) infection who developed persistent fever, skin rash, and multiple chest nodules visible on computed tomography 22–34 days after BCG vaccination. These infants were healthy before inoculation, and their detailed immunological profiles, including T cell and neutrophil levels, were within normal range. Most reported BCG cases involve impaired immunity, such as children with chronic granulomatous disease, severe combined immunodeficiency, or human immunodeficiency virus infections. Because of their immature immune systems, BCG vaccination can be hazardous even in early infants without immune abnormalities. Hence, we advise caution when administering BCG vaccines to early infants.