Comparison of Oral Erythromycin, Local Administration of Streptomycin and Placebo Therapy for Nonsuppurative Bacillus Calmette-Guérin Lymphadenitis

Bacille Calmette-Guérin (BCG) lymphadenitis is the most common complication of BCG vaccination. Two forms of BCG lymphadenitis can be recognised in its natural course—simple or non-suppurative lymphadenitis, which usually regresses spontaneously over a period of few weeks, and suppurative BCG lymphadenitis distinguished by the development of fluctuations in the swelling, with erythema and oedema of overlying skin. Healing in suppurative glands occurs through spontaneous perforation and sinus formation, followed by closure of the sinus by cicatrisation. Non-suppurative BCG lymphadenitis is best managed with expectant follow ups only, because medical treatment with erythromycin or antituberculous drugs do not hasten the regression or prevent development of suppuration. Suppurative BCG lymphadenitis may be treated by needle aspiration to hasten resolution and prevent spontaneous perforation and sinus formation. Surgical excision is rarely needed and is meant for cases of failed needle aspiration or for draining BCG nodes.

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“…[8][9][10] Risk is higher if vaccine is given during the newborn period. 6 Rapidly developing BCG lymphadenitis appears more likely to suppurate.…”

Section: Natural Coursementioning

confidence: 99%

Bacille Calmette-Guérin lymphadenitis

Goraya

Virdi

2002

Postgraduate Medical Journal

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“…12 Treatment options that have generally been taken in past for BCG adenitis include conservative follow up, anti-tubercular therapy, oral antibiotics mainly Erythromycin, needle aspiration, incision drainage and excision of lymphadenitis. [13][14][15] There is enough evidence to say that oral antibiotics and anti-tubercular treatment is not required. There is limited literature to prove the superiority of any one of the remaining treatment modalities over the others.…”

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confidence: 99%

BCG Adenitis: Action or Inaction?

Apte¹,

Sarkar²,

Sarkar³

2014

jemds

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“…4,5,6 However controlled studies have suggested that use of antibiotics neither reduces the risk of suppuration nor does it speed up healing. 7,8,9,10 Since non suppurative lymphadenitis usually heals on its own, it is better not to start antibiotics as they have their own side effects. 11 For suppurative lymphadenitis, it is advocated that needle aspiration causes rapid healing and prevents complications such as sinus and scar formation.…”

Section: Discussionmentioning

confidence: 99%

Upsurge in BCG Vaccine Induced lymphadenitis: Case Series

Manju¹,

Parida

Hegde³

et al. 2018

JYP

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Introduction: Tuberculosis is one of the serious healthcare concerns of the world today. The only vaccine available for tuberculosis till date is the BCG vaccine. It is one of the safest vaccine and is less commonly associated with adverse effects. However, recently we have seen an upsurge in number of BCG vaccine associated lymphadenitis in our hospital. Objective: To report the increase in number of BCG associated lymphadenitis cases in our hospital. Materials and methods: A total of ten cases of BCG associated lymphadenitis were seen in our hospital in the past one year. (May 2016 to April 2017) Data related to vaccination and the course of lymphadenitis was collected from the parents. Observations/Results: Out of the ten cases, 3 were vaccinated outside while the remaining infants were vaccinated in our hospital. Three out of the ten infants required intervention and remaining 7 were reassured and followed up, the swelling subsided in most of them. The most probable cause of the increased incidence in our hospital could be because of a particular batch of vaccine containing an altered strain/ change in the number of viable organism. Conclusion: We are reporting the cases as it might lead to an awareness among other practitioners and will also provide a scope for further studies. Increased surveillance and appropriate treatment guidelines for BCG vaccine associated lymphadenitis is the need of the hour. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Comparison of Oral Erythromycin, Local Administration of Streptomycin and Placebo Therapy for Nonsuppurative Bacillus Calmette-Guérin Lymphadenitis

Cited by 22 publications

References 8 publications

Bacille Calmette-Guérin lymphadenitis

Bacille Calmette-Guérin lymphadenitis

BCG Adenitis: Action or Inaction?

Upsurge in BCG Vaccine Induced lymphadenitis: Case Series

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