Management of Suppuration in Regional Lymph Nodes Secondary to BCG Vaccination

Abstract

We describe 50 patients with suppurative regional lymphadenitis following intradermal BCG vaccination. For non‐drained suppurations we performed needle aspiration in twenty‐three patients (aspiration group). Of the remaining 27 patients (drainage group) 16 had spontaneous drainage and 11 incisional drainage. In the drainage group, 17 patients were followed up conservatively. Ten patients from the drainage group and 3 patients from the aspiration group (drained after needle aspiration) accepted total surgical excision to terminate the drainage. Twenty of twenty‐three patients in the aspiration group recovered after needle aspiration. Average period of cessation of drainage and healing of wound was 7.5 weeks in patients with drainage (spontaneous and incisional). Healing was complete after total surgical excision of draining suppurations in all of 11 patients. We concluded that simple needle aspiration was sufficient for the treatment of suppurating but non‐drained BCG lymphadenitis. For suppurating lymph nodes that were surgically (not recommended) or spontaneously drained, a more invasive procedure, total surgical excision, was proposed to terminate the long and disturbing drainage period.

Bacille Calmette-Guerin Lymphadenitis: A single center experience

“…This is consistent with what Hengster and colleagues had demonstrated; that needle aspiration is not an alternative to surgical excision of caseating lymph nodes [13]. Caglayan et al [14] found that the treatment of choice for suppurative lymphadenitis is surgical excision. Studies have shown that postoperative anti tuberculosis medications are not recommended [13,14].…”

“…Caglayan et al [14] found that the treatment of choice for suppurative lymphadenitis is surgical excision. Studies have shown that postoperative anti tuberculosis medications are not recommended [13,14]. In our study, medical treatment was implemented in patients who had suppurative complications and complete healing was achieved in all patients.…”

Suppurative supraclavicular bacille calmette-guerine lymphadenitis - A case report, awareness and management options

“…For suppurative lymphadenitis simple needle aspiration was found useful, as regression was signifi cantly faster than in non-treated group and spontaneous rupture was less frequent. [6,9] Sometimes needle aspiration had to be repeated. Incision and drainage was universally condemned due to poor wound healing, persistent discharge, sinus formation, scarring and delayed recovery.…”

Role of Needle Aspiration in Diagnosis and Management of Suppurative Bacille Calmette–Guerin Adenitis: An Institutional Study of 30 Cases

“…[ 2 ] Suppurative lymphadenitis is diagnosed with the appearance of fluctuation in the lymph node swelling, erythema and edema of the overlying skin. [ 12 13 ] It is seen in (30–80) % of cases of the cases of BCG lymphadenitis. [ 12 ] If not treated properly, it is followed by spontaneous rupture, ulceration, sinus formation, cicatrization and healing with scarring; which involve several months.…”