BACILLUS CALMETTE-GUERIN (BCG) LYMPHADENITIS- CHANGING TRENDS AND MANAGEMENT

Zafar Nazir, Saqib Hamid Qazi

Abstract


Background: Bacillus Calmette-Guérin (BCG) vaccination is performed as a part of expanded
Programme of Immunization (EPI). Suppurative lymphadenitis is the common complication of BCG
vaccination. The optimum treatment for this complication is debated. Methods: All cases of BCG
lymphadenitis presenting to pediatric surgical service over a 17-year study period were reviewed to
determine the optimum treatment for this problem. Results: Sixty children were referred for the
management of BCG lymphadenitis during the study period. Most patients (n=43) presented during
1988 and 1990. Children were healthy and received BCG (Pasteur strain) vaccination at EPI during
first 2 months of life. Initially all the patients received medical treatment with anti-tuberculous drugs
for one to nine months. Fifty-two children who presented with large (~ 3cm) fluctuant lymph nodes,
required a surgical procedure to avoid spontaneous rapture and sinus formation (Group A), whereas
medical treatment was effective in five out of eight patients presenting with small (~1 cm) nodes
(Group B). Conclusions: Medical treatment with antituberculous drugs is not effective to treat BCG
lymphadenitis, when the involved lymph nodes are around 3.0 cm and have developed fluctuation and
inflammation of over lying skin.
Keywords: Vaccination, BCG vaccine, Lymph node, Lymphadenitis

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