Long-term outcomes of BCG osteomyelitis in infants: Epiphyseal regeneration and minimal leg-length discrepancy after 10 years

Bacillus Calmette-Guérin (BCG) is a vaccine to prevent tuberculosis. Complications in infants and children include BCG osteitis and osteomyelitis of the metaphysis or epiphysis of long bones. There have been few reports of long-term follow-up. We investigated 10-year outcomes based on X-rays and physical examinations. We described two individuals who developed BCG osteomyelitis after vaccination (Tokyo 172 strain) at 3 months old. Both cases underwent a biopsy of the infected epiphyseal lesion, irrigation from the metaphysis through the center of the growth plates, and received two anti-tuberculosis drugs: rifampicin and isoniazid. At the 10-year follow-up, the affected epiphysis had regenerated and both cases showed a leg-length discrepancy of less than 1 cm due to overgrowth. This study reported on the long-term outcomes of two cases of BCG epiphyseal osteomyelitis in infants, revealing favorable results with regenerated epiphysis and minimal leg-length discrepancy.