BACILLUS CALMETTE-GUERIN (BCG) LYMPHADENITIS- CHANGING TRENDS AND MANAGEMENT
Abstract
Background: Bacillus Calmette-Guérin (BCG) vaccination is performed as a part of expandedProgramme 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
References
Milstien JB, Gibson JJ. Quality control of BCG vaccine by
WHO: a review of factors that may influence vaccine
effectiveness and safety. Bulletin of the World Health
organization 1990; 68:93-108.
Bannon MJ. BCG and tuberculosis. Arch Dis Child 1999; 80:
-3.
Karnak I, Senocak ME, Buyukpamukcu N, Gocmen A. Is BCG
vaccine innocent? Pediatr Surg Int 1997; 12: 220-223.
Sadeghi E, Kumar PV. Eczema vaccinatum and post BCG
adenitis. Tubercle 1990; 71:145-6.
Peltola H, Salmi I, Vahvanen V. BCG vaccination as a cause of
osteomyelitis and subcutaneous abscess. Arch Dis Child 1984;
:157-61.
Kroger L, Brander E, Korppi M, Wasz-Hockert O, Backman A,
Kroger H et al. Osteitis after newborn vaccination with three
different Bacillus Calmette- Guerin vaccines: twenty-nine years
of experience. Pediatr Infect Dis J 1994;12:113-6.
Aggarwal NP, Kallan BM, Grover PS, Aggarwal M. ClinicoExcisional study of lymphadenitis following BCG vaccination.
Indian J Pediatr 1990;57:585-6.
Merry C, Fitzgerald RJ. Regional lymphadenitis following BCG
vaccination. Pediatr Surg Int 1996;11:269-71.
Praveen KN, Smikle MF, Prabhakar P, Pande D, Johnson B,
Ashley D. Outbreak of Bacillus Calmette-Guerin Associated
lymphadenitis and abscesses in Jamaican children. Pediatr Infect
Dis J 1990;9:890-3.
Hengster P, Solder B, Fille M, Menardi G. Surgical treatment
of Bacillus Calmette Guerin Lymphadenitis. World J Surg 1997;
:520-3.
Hengster P, Schnapka J, Fille M, Menardi G. Occurrence of
suppurative lymphadenitis after a change of BCG vaccine. Arch
Dis Child 1992;67:952-5.
Close GC, Nasiiro R. Management of BCG adenitis in infancy.
J Trop Pediatr 1985;31:286-9.
Murphy PM, Mayers DL, Brock NF, Wagner KF. Cure of
Bacilli Calmette - Guerin vaccination abscess with
erythromycin. Rev Infect Dis 1989; 11:335-7.
Hanley SP, Gumb J, Macfarlane JT. Comparison of
Erythromycin and Isoniazid in treatment of adverse reaction to
BCG vaccination. Br Med J 1985; 290:970-3.
Caglayan S, Yegin O, Kayran K, Timocin N, Kasirga, Gun M.
Is medical therapy effective for regional lymphadenitis
following BCG vaccination? AJDC 1987; 141:1213-4.
Caglayan S, Arikan A, Yaprak I, Aksoz K, Kansoy S.
Management of suppuration in regional lymph nodes secondary
to BCG vaccination. Acta Paediatr Jpn 1991; 33: 699-702.
Banani SA, Alborzi A. Needle aspiration for suppurative postBCG adenitis. Arch Dis child 1994; 71: 446-7.
Rafi S, Ahmed A, Ramazan M, Billo AG. BCG lymphadenitis:
A study of knowledge, attitude and practice of mothers
including effect on completion vaccination schedule. J Coll
Physicians Surg Pakistan 1994; 4: 80-2.
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