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Int Wound J. 2017 Dec;14(6):1385-1387. doi: 10.1111/iwj.12755. Epub 2017 Apr 19.

BCG vaccination-induced suppurative lymphadenitis: four signs to pay attention to.

Author information

1
Department of Plastic Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
2
Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Abstract

Suppurative lymphadenitis is one of the severe complication after BCG vaccination, but its diagnostic criteria and treatment guidelines have not yet been established. In this article, we describe a case of suppurative lymphadenitis caused by BCG vaccination and propose diagnostic criteria and treatment guidelines of the disease. The lymphadenitis was presented as skin involving mass and was completely extirpated. Pathological evaluation revealed a necrotising lymphadenitis, consistent with the diagnosis of BCG lymphadenitis. The patient was administered adjuvant medical treatment with anti-TB medications (Isoniazid and Rifampicin) for 3 months. At 6 months follow-up, the disease was in complete remission without complications. We recommend focus on the following four signs when diagnosing BCG lymphadenitis: (i) previous history of vaccination on the ipsilateral side of the lesion, (ii) absence of any other infection signs, (iii) absence of fever and (iv) isolated axillary or supraclavicular/cervical lymph node enlargement proven by ultrasonography or computed tomography scan. BCG vaccination-induced suppurative lymphadenitis can easily be overlooked, but prompt, accurate diagnosis followed by appropriate surgical resection should result in complete healing as in this case.

KEYWORDS:

Abscess; BCG vaccine; Lymphadenitis; Tuberculosis

PMID:
28425207
DOI:
10.1111/iwj.12755
[Indexed for MEDLINE]

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