Peer-reviewed article
Case Report: Contezolid-containing regimens for disseminated Bacillus Calmette–Guérin disease in three children with primary immunodeficiency
Zhen Zhang, Junchi Xu, Li Gao, Junjia Liu, Zhijian Ye et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This case series describes three infants aged 3 to 9.5 months with primary immunodeficiency who developed disseminated BCG disease after routine vaccination. They were treated with contezolid, a newer antibiotic, alongside other anti-mycobacterial drugs and stem cell transplantation. All three recovered clinically and none relapsed during one year of follow-up. No serious side effects were attributed to contezolid. Because the children also received a transplant and several other drugs, the role of contezolid alone cannot be separated out.
Key points
- Three children (aged 3–9.5 months) had Wiskott–Aldrich syndrome, X-linked severe combined immunodeficiency, or IL-12 receptor β1 deficiency.
- Contezolid was given at 12–20 mg/kg/dose every 12 hours for 11–12 months with other antimycobacterial agents and HSCT.
- All patients achieved satisfactory clinical resolution of infectious lesions, with no clinical relapse after 1 year of telephone follow-up.
- No hematological, hepatic, renal, or neurological adverse events were attributed to contezolid.
- Contezolid may be an alternative when linezolid is poorly tolerated, but its independent contribution cannot be determined.
Limitations
Only three children were studied, with no comparison group, and all received concurrent stem cell transplantation and multiple drugs, so the effect of contezolid cannot be isolated. Follow-up after treatment was by telephone only.
Abstract
Introduction Disseminated Bacillus Calmette–Guérin (BCG) disease is a rare but life-threatening complication in children with primary immunodeficiency (PID). Linezolid (LZD) is effective but limited by myelosuppression. Contezolid (CZD), a novel oxazolidinone, has shown better hematological safety in adults, but pediatric data are scarce. This retrospective case series aims to provide real-world experience on CZD use in this challenging population. Case description We report three children (aged 3–9.5 months) with PID (Wiskott–Aldrich syndrome, X-linked severe combined immunodeficiency, and IL-12 receptor β1 deficiency) who developed clinically presumed or confirmed disseminated BCG disease after routine vaccination. All received CZD-containing regimens (12–20 mg/kg/dose, q12 h) alongside other antimycobacterial agents and hematopoietic stem cell transplantation (HSCT). Outcomes Over 11–12 months of CZD-containing multidrug therapy followed by 1 year of post-treatment telephone follow-up, all patients achieved satisfactory clinical resolution of infectious lesions and no clinical relapse was observed. No CZD-attributable hematological, hepatic, renal, or neurological adverse events occurred. However, because all patients received concurrent HSCT and multiple antimycobacterial agents, the independent contribution of CZD cannot be determined. Conclusion CZD-containing regimens were well tolerated and associated with clinical improvement in these complex cases. CZD may serve as a valuable alternative when LZD is poorly tolerated. However, definitive attribution of efficacy to CZD alone is precluded by concurrent HSCT and multi-drug therapy.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Contezolid-containing multidrug antimycobacterial regimens combined with hematopoietic stem cell transplantation
- Population
- Three infants aged 3–9.5 months with primary immunodeficiency in China (Wiskott–Aldrich syndrome, X-linked SCID, IL-12 receptor β1 deficiency)
Key finding
All three patients achieved satisfactory clinical resolution of infectious lesions after 11–12 months of treatment.
Zhang et al. · OpenAlex · 2 Oct 2026