Bacille calmette-guerin lymphadenitis: a single center experience

ABSTRACT

To describe the clinical presentation, course and management of lymphadenitis post Bacille Calmette-Guerin vaccine. This descriptive study was conducted on 17 cases who were referred to the infectious disease clinic at King Hussein Medical Center with regional lymphadenitis post Bacille Calmette-Guerin vaccine. All cases were infants between two and 12 months of age. The results of lymph node aspirate and biopsy were shown as well. Different treatment protocols used were included. The study was conducted from September 2006 to September 2007. Seventeen patients, 9 males [52%] and 8 females [48%], were studied. Constitutional symptoms were found only in one infant. All infants received the same type of vaccine used by our Ministry of Health which is the Danish strain. Unilateral axillary lymph node enlargement was seen most commonly [47%]. Cervical lymph nodes were involved in four cases [24%] followed by supraclavicular lymphadenopathy in three cases [18%], and one case had cervical and supraclavicular lymphadenopathy. Sinus formation was seen in three [18%] cases. Five cases [30%] had fluctuating lymph nodes. Only one infant had disseminated infection. The majority [65%] of cases had their symptoms starting within the first two months post vaccine. Eight [47%] infants had conservative observational management. Anti-tuberculosis medications were used in five [30%]. Surgical approach was used in four [23%] cases. All infants had complete healing by the end of the study period. Since the introduction of the new vaccine more complications are seen. This stresses the importance of early recognition and implementation of appropriate treatment protocols. Complete healing of suppurative lymphadenitis post Bacille Calmette-Guerin vaccine can be achieved using different treatment protocols