Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The practical elements of BCG vaccination in neonates are used in most developing countries are outlined. The World Health Organization that all neonates be vaccinated, as well as all unvaccinated children when they present for health care, without prior PPD testing. BCG vaccine is a live attenuated TB vaccine in lyophilized state, so it must be kept cold and away from light. After redissolving, the vaccine is given intradermally with a 0.45% 10 mm needle either on the volar left forearm or the posterior left arm, at a consistent site in each country. The dose must be 0.05 ml for babies 1 year old, and 0.1 ml for older children. A wheal is formed that disappears in 30 minutes, followed by a red nodule in 3-4 weeks. The depressed scar is evidence of vaccination. In rare cases, lymphadenitis may appear, sometimes with a fistula. This is more likely when 0,1 ml is given to infants, the vaccine is not diluted properly, or the injection is given too deeply. While immunodeficiency is considered a contraindication for BCG vaccination, infants born to HIV-positive mothers have received it without adverse effects. Other immunizations such as oral polio may be given concomitantly. Verification of BCG vaccination is by presence of the scar or PPD testing. About 30-50% of children entering school are still positive; negative children may be revaccinated.
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PMID:BCG vaccination. 1234 45

A 15-year-old, unmarried female presented to our dermatology department for an intensely pruritic skin rash that had appeared abruptly 3 days earlier. She had a remarkable medical history for a case of allergic rhinitis and several attacks of asthma in her early childhood. The condition waxed and waned initially but had improved in recent years. Physical examination revealed several erythematous plaques, papules studded with scattered pustules having diameters less than 0.3 mm. Conspicuous scratch marks had caused erythematous wheal-like indurations also studded with pustules in a linear distribution across the waist, forearms (Fig. 1), and back (Fig. 2). Discrete papulopustules were present on the face, nape and neck. The patient was otherwise healthy. There were no other symptoms such as fever, malaise, weakness, or lymphadenopathy Laboratory results were normal for hepatic and renal functions, serum electrolytes, glucose, protein, erythrocyte sedimentation rate (8 mm/h), and C-reactive protein (0.355 mg/l). A human immunodeficiency virus (HIV) antibody screen test was negative. Serum was positive for herpes simplex virus (HSV)-1 and HSV-2 IgG (in low titers), but negative for HSV-1 and HSV-2 IgM. White blood cell count revealed leukocytosis (11.2 x 10(3)/l), with a differential count of 68% neutrophils, 27% lymphocytes, and 8% eosinophils. Serum IgA, IgG, and IgM were within normal limits, but the IgE level was elevated (677 mg/dl). Cultures from peripheral blood and pustules were negative. A Tzank smear performed on the pustules showed no multinucleated giant cells. Fungal testing of skin scrapings from the initial lesion site gave negative results. Routine stool tests, including common pathogen and parasite screens, were negative, and urinalysis results were unremarkable. A biopsy specimen obtained from a skin pustule showed subcorneal eosinophilic and neutrophilic pustules in the follicular infundibulum with marked spongiosis of the follicular epithelium. (Fig. 3). There was a moderately dense superficial and deep perivascular mixed inflammatory cell infiltrate comprising eosinophils, neutrophils and lymphocytes. Migration of eosinophils and neutrophils through the vessel wall with variable luminal intramural fibrin deposition, histologically indicative of vasculopathy, was seen. There was concomitant slight perivascular dermal necrosis. (Fig. 4). Based on the clinical presentation and light microscopic findings on biopsy, a diagnosis of eosinophilic pustular folliculitis with pathergy was made. Systemic prednisolone 30 mg in divided doses was given. After 1 week of systemic corticosteroid therapy, the patient's condition was significantly improved and the patient was subsequently discharged. Two months later she had a relapse, upon which corticosteroid therapy was commenced leading to lesional resolution. The foci of eosinophilic folliculitis healed with areas of hyperpigmentation with variable scarring.
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PMID:Pathergy in atypical eosinophilic pustular folliculitis. 1580 26