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

Authors

  • Zafar Nazir
  • Saqib Hamid Qazi

Abstract

Background: Bacillus Calmette-Guérin (BCG) vaccination is performed as a part of expandedProgramme of Immunization (EPI). Suppurative lymphadenitis is the common complication of BCGvaccination. The optimum treatment for this complication is debated. Methods: All cases of BCGlymphadenitis presenting to pediatric surgical service over a 17-year study period were reviewed todetermine the optimum treatment for this problem. Results: Sixty children were referred for themanagement of BCG lymphadenitis during the study period. Most patients (n=43) presented during1988 and 1990. Children were healthy and received BCG (Pasteur strain) vaccination at EPI duringfirst 2 months of life. Initially all the patients received medical treatment with anti-tuberculous drugsfor 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), whereasmedical 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 BCGlymphadenitis, when the involved lymph nodes are around 3.0 cm and have developed fluctuation andinflammation of over lying skin.Keywords: Vaccination, BCG vaccine, Lymph node, Lymphadenitis

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