J Korean Pediatr Soc.  2002 Apr;45(4):454-458.

Local Rifampicin Instillation Therapy for Suppurative Bacillus Calmette-Guerin Lymphadenitis

Affiliations
  • 1Department of Pediatrics, Kangnam General Hospital Public Co., Seoul, Korea. jsh@kangnamhosp.or.kr
  • 2The Korean National Tuberculosis Association, Seoul, Korea.

Abstract

PURPOSE: Bacillus Calmette-Guerin(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis.
METHODS
The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis.
RESULTS
Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt.
CONCLUSION
Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.

Keyword

Suppurative BCG lymphadenitis; Local rifampicin instillation therapy

MeSH Terms

Abscess
Bacillus*
Drainage
Follow-Up Studies
Humans
Infant
Isoniazid
Lymph Nodes
Lymphadenitis*
Mycobacterium bovis
Needles
Pan American Health Organization
Rifampin*
Vaccination
Isoniazid
Rifampin
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