Ranchod, HeenaHoward, WayneRoux, AdeleVan Zyl, Walda B.Ekermans, PieterVan den Berg, SylviaSeakamela, LeratoMakua, KoketsoYousif, MukhlidSibiya, RosinahDu Plessis, HeleenPhalane, EmmanuelMcCarthy, KerriganMoonsamy, ShelinaReynders, DavidHincks, JeffreySuchard, Melinda S.Du Plessis, Nicolette Marie2024-02-212024-02-212024-01Ranchod, H., Howard, W., Roux, A. et al. 2024, 'Stem cell transplant in immune-deficiency-associated vaccine-derived poliovirus', Open Forum Infectious Diseases, vol. 11, no. 2, art. ofad678, pp. 1-5, doi : 10.1093/ofid/ofad678.2328-8957 (online)10.1093/ofid/ofad678http://hdl.handle.net/2263/94769Patients with severe primary immunodeficiency are at risk for complications from live-attenuated vaccines. Here, we report a case of a vaccine-associated paralytic polio and Bacille Calmette-Guérin disease in a 6-month-old girl with severe combined immunodeficiency resulting from homozygous recombinant activating gene 1 deficiency. The patient was successfully treated with intravenous immunoglobulins and oral pocapavir for poliovirus, and antimycobacterial therapy for regional Bacille Calmette-Guérin disease, allowing stem cell transplant. Following transplantation, poliovirus type 3 with 13 mutations was detected from cerebrospinal fluid but not from stool, indicating ongoing viral evolution in the central nervous system despite pocapavir treatment. Clinical improvement and immune reconstitution allowed the patient to be successfully discharged with no further detection of poliovirus.en© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.Acute flaccid paralysisBacille Calmette-Guérin (BCG) diseaseDisseminated BCGImmunodeficiencyIntravenous immune globulinImmune reconstitution inflammatory syndrome (IRIS)Immunodeficiency-related vaccine-derived polioviruses (iVDPVs)PocapavirPolioPoliomyelitisRAGSevere combined immunodeficiency (SCID)Stem cell transplantTransplantVaccine-associatedVaccine-derived poliovirusVAPPSDG-03: Good health and well-beingArticle