BCG dissemination in a newborn with immunodeficiency and in a boy with normal immunity

Two patients with BCG-dissemination are presented. In the first patient BCG-dissemination (M. bovis) was incontestably caused by deranged cellular immunity. The tuberculine test and candidine test were repetedly negative, the number of lymphocytes decreased, the macrophage inhibition migration to PPD default. All these findings as well as clinical development indicated impaired cellular immunity; especially varicella infection was fatal to the patient. In the second patient all tests for humoral and cellular immunity were normal; so BCG dissemination (M. bovis) is hardly to explain. M. bovis (BCG sort) was found in the neck lymphonodes and in the gastrolavage. Citologically, a granulomatosuos inflammation in the lymphonodes and the bronchial mucus was found. Lsh (Ity) BCG gen, NRAMP, identified in mice, oncodes an integral membrane protein; it has a macrophage-specific-membrane-transport function. A human homologous is localised to the long arm of chromosome 2. The future will show if a similar gene controls natural resistance to intracellular agents. We presume that the BCG-dissemination in our patients was caused by deranged macrophage function.