Bacillus Calmette–Guérin osteomyelitis of the fifth metatarsal bone in a Japanese infant: a case report

Bacillus Calmette–Guérin osteomyelitis is a rare complication following Bacillus Calmette–Guérin vaccination. Here, we describe a rare case of Bacillus Calmette–Guérin osteomyelitis of the fifth metatarsal in a 21-month-old Japanese infant. A 21-month-old Japanese female infant presented with a swollen mass on the dorsolateral aspect of the left foot. Based on physical examination, radiological and histopathologic findings and laboratory results, a diagnosis of Bacillus Calmette–Guérin osteomyelitis of the fifth metatarsal bone was made, and an oral anti-tuberculosis treatment was initiated. However, the mass recurred 10 months after the start of the anti-tuberculosis treatment, so additional surgical debridement was performed. Six months after surgery, clinical findings and plain radiograph images revealed complete improvement of the affected area, and anti-tuberculosis treatment was stopped. Bacillus Calmette–Guérin osteomyelitis of the fifth metatarsal in a 21-month-old Japanese infant was successfully treated with oral anti-tuberculosis therapy and surgical debridement.