A Clinical Study on BCG Lymphadenitis

ABSTRACT

PURPOSE: We studied the incidence and clinical course of BCG lymphadenitis to investigate the BCG related problem. SUBJECT AND METHODS: Three hundred and eighty-six infants received BCG vaccine (Pasteur-1173p2) in the Well Baby Clinic, Dept. of Pediatrics, Chonnam University Hospital from May 1993 and April 1994. Among them, twenty three infants developed regional lymphadenitis. We investigated the clinical course in twenty six infants with BCG lymphadenitis (three infants were transferred from the Public Health Center and they also had taken same BCG preparations). According to the lymph node size, we divided them into three groups (A below 1cm, 5 infants; B 1 to 2cm, 10; C above 2cm, 11), and evaluated the clinical outcome. RESULTS: 1) The incidence of BCG lymphadenitis was 6.0% (23/386), the differences according to sex or age at vaccination were not observed. 2) Twenty three of twenty six infants (88.5%) showed one lymph node (left axillary 19 infants, left cervical 3 infants, left supraclaviclar 1 infant), but three (11.5%) showed multiple lymph node involvement. 3) Eight (30.8%) showed spontaneous improvement, but eighteen (69.2%) received single or double antituberculous medication at the beginning or after a period of observation. Two infants were treated by incision and drainage. CONCLUSIONS: The incidence of BCG lymphadenitis was relatively higher (6.0%) than previous reports, and the two thirds of the cases received antituberculous medication and or surgical treatment. Further prospective study according to the recent recommendation by the Korean Health Administration should be needed.