Estimation of economic burden of bacillus Calmette-Guérin lymphadenitis in Shandong Province based on compensation for abnormal reaction to vaccination / 中华预防医学杂志

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q1,Q3) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q1,Q3) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.

Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, 2012 / Bartonella henselae in children with regional adenitis treated in a Peruvian national hospital, 2012

Con el objetivo de determinar la frecuencia de casos seropositivos a Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú, se realizó un estudio trasversal en 106 niños con adenitis regional mayor de 1 cm de diámetro, de aparición aguda, con tiempo de enfermedad mayor de cinco días, atendidos en el Instituto Nacional de Salud del Niño durante el año 2012. Se definió seropositividad para B. henselae mediante el examen de inmunofluorescencia indirecta, siendo positivos 86 niños (81,1%) con una mediana de edad de 7 años, rango de 5 a 11; en el análisis bivariado se encontraron como factores asociados, edad mayor de 5 años, antecedentes de fiebre, adenopatía mayor de 4 cm y reporte de contacto con gato. En conclusión, los niños con adenitis regional atendidos en este hospital de referencia nacional presentaron una frecuencia alta de serología positiva para B. henselae.

In order to determine the frequency of seropositive cases of Bartonella henselae in children with regional adenitis treated in a national hospital in Peru, a cross-sectional study was conducted in 106 children with regional adenitis greater than 1 cm in diameter. The sample was selected from patients aged 5-11 years seen at the National Institute of Child Health for acute onset of regional adentitis, with more than five days of symptoms. B. henselae seropositivity was defined by indirect immunofluorescence test. We found that 86 children (81.1%) were positive for B.henselae. The median age of the patients was 7 years. In the bivariate analysis, the following associated factors were found: aged 5 years, history of fever, lymphadenopathy greater than 4 cm and reported contact with cat. In conclusion, children with regional adenitis treated in this national referral hospital showed a high frequency of positive serology for B. henselae.

Bacillus Calmette-Guerin lymphadenitis: A 6-year experience in two Saudi hospitals.

Background : The World Health Organization (WHO) has recommended Bacillus Calmette-Guerin (BCG) vaccination as a part of the global expanded program for immunization. Although the BCG vaccine is usually a safe vaccine, a number of complications with lymphadenitis being the most common complication, can occur. Aim : We evaluated the frequency, the clinical presentation and treatment modalities of lymphadenitis after BCG vaccine in Saudi children. Results : A total of 145 patients with BCG lymphadenitis presented between January 2005 and December 2010. In the majority (103) of the cases, the lymphadenitis involved ipsilateral left axillary nodes. Other sites of involvement included the left supraclavicular lymph nodes in 26 (18%) patients, and both the left axillary and supraclavicular lymph nodes were involved in 7 cases (4.8%). A total of 75 patients (65%) were given antituberculous medication. Eight (27%) patients had positive acid-fast bacilli and positive cultures for Mycobacterium bovis. Conclusion : In light of the findings of this study, it would be advisable to administer the BCG vaccine in Saudi Arabia at a time later than at birth, as the younger children are commonly affected.

Outbreak of Bacille Calmette-Guerin-related lymphadenitis in Saudi children at a university hospital after a change in the strain of vaccine

Bacille Calmette-Guerin [BCG] vaccination is part of the expanded program of vaccination in Saudi Arabia. Lymphadenitis is the most common complication of the BCG vaccine. We observed an increase in the rate of BCG lymphadenitis that coincided with the introduction of a new strain of BCG vaccine. The aim of this study was to determine the incidence and the possible causes of BCG lymphadenitis at a university hospital in Riyadh, Saudi Arabia. Retrospective chart review and prospective follow up of infants who received BCG vaccine. We studied all infants presenting with suppurative or nonsuppurative adenopathy with nodes >/= 2 cm seen at the infectious diseases clinic at KKUH. The study duration was divided into two periods. The first period reviewed infants who received different BCG vaccine strains between January 2002 and December 2007. The second study period was conducted after close evaluation of the BCG administration technique of the vaccinating staff and reviewed infants who received the BCG SSI Danish strain 1331 between January 2008 and December 2010.During the study period from January 2002 to December 2007, 19 402 infants received four different BCG vaccine strains. Eight infants developed BCG lymphadenitis, and all were associated with the BCG SSI vaccine. The incidence rate in 2007 was 1.96 per 1000. In the second period, 66 of 9921 infants who received the BCG SSI vaccine developed BCG lymphadenitis between January 2008 and December 2010. The incidence rate was 10.14 per 1000 in 2010. We conclude that receipt of the BCG SSI vaccine might have contributed to the increased incidence of lymphadenitis in these children. Hence, caution should be exercised in switching from one vaccine to another, as is often done in developing countries

The Prevalence of Yersinia Infection in Adult Patients with Acute Right Lower Quadrant Pain / 대한소화기학회지

BACKGROUND/AIMS: Clinical manifestations of intestinal yersiniosis include enterocolitis, mesenteric adenitis, and terminal ileitis presenting with fever, right lower quadrant pain, and leukocytosis. According to a previous Korean study in 1997, Yersinia was revealed in two among 15 adult patients with mesenteric adenitis (13%). However, recent reports on the prevalence of Yersinia infection in adult patients are few. The aim of this study was to investigate the prevalence of Yersinia infection in adult patients with acute right lower quadrant pain. METHODS: Adult patients (>18 years) who visited Eulji medical center, due to acute right lower quadrant pain were enrolled prospectively from December 2007 to July 2009. Abdominal CT, stool culture, serologic test for Yersinia, and Widal test were performed. RESULTS: Among 115 patients, 5 patients were excluded due to positive Widal test or salmonella culture. In 110 patients, abdominal CT showed right colitis in 20 (18.2%), terminal ileitis in 16 (14.5%), mesenteric adenitis in 13 (11.8%), acute appendicitis in 10 (9.1%), acute diverticulitis in 7 (6.4%), non specific mucosal edema in 36 (32.7%) and no specific lesion in 8 (7.3%). Two (1.8%) of the 110 patients had antibodies to Yersinia. One patient showed acute enteritis and the other patient was diagnosed with acute appendicitis and underwent appendectomy. No Yersinia species were grown on stool or tissue culture. CONCLUSIONS: Nowadays, among adult Korean patients presenting with acute right lower quadrant pain, there have been few incidences of Yersinia infection.

clinicomorphological study of lymphadenopathy

A total 238 lymph nod specimen were studied at various Hospitals of Lahore. The ages of these patients ranged from 2 years to 80 years. Maximum number of patients with lymphadenopathy [90 out of 238] 37.8% cases were in 10-19 years age group. Females [51.7%] presenting with lymph node enlargement were more affected than males [48.3%]. The commonest presenting complaint was fever [56.3%]. Cervical lymph nodes [80.3%] were the commonest site of involvement. On histopathological examination, seven morphological groups were highlighted; tuberculous lymphadenitis [42.5%], chronic nonspecific lymhadenitis [36.6%], viral lymphadenitis [3.4%] acute bacterial lymphadenitis [0.8%]. Fungal lymphadenitis [0.8%], Metastatic carcinoma [11.3%] and lymphomas [4.6%]

Prevalence of BCG adenitis in infants vaccinated at birth

BCG vaccine is a safe and effective product. The most common side effects are ulceration at the site of vaccination and also regional lymphadenitis. The risk of suppurative lymphadenitis is more common in neonates than in infants and children. To detect the prevalence of BCG adenitis in vaccinated infants and also evaluating the correlation between incidence of BCG adenitis and sex, birth weight and gestational age of neonates. This was a retrospective analytical study in which 500 infants vaccinated at birth were evaluated for presence of BCG adenitis using a questionnaire. The correlation between occurrence of BCG adenitis and sex, gestational age and birth weight of neonates was analyzed by chi-square test. The prevalence of BCG adenitis was 6%. No positive correlation between occurrence of BCG adenitis and the neonate sex was found. However, there was a positive correlation between occurrence of BCG adenitis and both the neonate birth weight and gestational age [p<0.05]. Based on data found in our study, more attention to gestational age and birth weight is recommended to reduce the occurrence of BCG vaccine complications

Fatores de risco associados à ocorrência de linfadenite em suínos na fase de crescimento-terminação / Risk factors at the growth-termination phase associated with the occurrence of lymphadenitis in swine

Realizou-se estudo epidemiológico em 60 unidades de terminação de suínos (UT), pertencentes a produtores integrados às principais agroindústrias dos Estados de Santa Catarina e Rio Grande do Sul. Esses produtores foram selecionados em função da ocorrência de linfadenite em lotes de suínos abatidos. O tamanho dos lotes acompanhados em cada UT variou de 22 a 960 suínos. Os animais foram considerados positivos ou negativos para linfadenite, pela avaliação de rotina do Serviço de Inspeção Federal (SIF) no abate. Para coleta dos dados nas UT, foi aplicado um questionário com 156 variáveis em uma única visita às granjas. Nos lotes das 60 UT estudadas, a percentagem de animais positivos para linfadenite foi de 10,37 por cento. Do conjunto de variáveis analisadas foram identificados nove fatores de risco (variáveis explicativas) associados à ocorrência de linfadenite (variável objetiva), os quais são: a má higiene dos comedouros e bebedouros, a água não tratada, a má conservação das instalações, o transporte de ração e animais com o mesmo caminhão, a produção de ração na propriedade, o acesso de outros animais à fabrica de ração, a estocagem de ração pronta em caixas ou sacos e o manejo na produção de animais em sistema contínuo.

Histochemical stainings, biological cultures and therapeutic responses of granulomatous lymphadenitis in Ramathibodi Hospital-prospective study of 57 cases.

The study was designed to delineate the etiology of granulomatous lymphadenitis which is one of the most common lesions encountered in our routine surgical pathology practice. Fifty-seven lymph nodes diagnosed histopathologically as granulomatous lymphadenitis were cultured and stained by special histochemical stains for tuberculosis, fungus, anaerobic and aerobic bacteria. M.tuberculosis was isolated in 60-70 per cent of lesions. The remaining 30-40 per cent of the lesions failed to demonstrate any infectious agent but most of the available follow-up cases showed satisfactory response to antituberculous drugs. Ziehl-Neelsen's stain showed very low sensitivity but excellent specificity and is still recommended for use to differentiate from other infectious agents in the areas where infectious agents are prevalent.