Affiliations: Department of Pediatrics, King Hussein Medical Center,
Amman, Jordan | Infection Control Manager, King Hussein Medical
Center, Amman, Jordan | Department of Pediatric Infectious Diseases, Hurley
Medical Center, Michigan State University, Flint, MI, USA
Note: [] Correspondence: Dr. Walid Abuhammour, M.D., Hurley Medical
Center, Pediatric Infectious Diseases, Michigan State University, One Hurley
Plaza, 48098, Flint, MI, USA. Tel.: +1 8102409698; Fax: +1 8102409698; E-mail:
[email protected]
Abstract: To describe the clinical presentation, course and management of
infants that presented with the diagnosis of lymphadenitis after Bacille
Calmette-Guerin (BCG) vaccination. This is a descriptive study of 89 patients
that were referred to the pediatric infectious disease clinic at King Hussein
Medical Center in Jordan with regional lymphadenitis after BCG vaccination. The
presentation, course and treatment options of these cases were discussed. The
study was conducted between September 2006 and September 2007. Eighty-nine
patients (47 males (53%) and 42 females (47%) were studied. All infants
received the same type of vaccine used by our Ministry of Health, which is the
Danish strain. Unilateral axillary lymph node enlargement was the most commonly
seen (47%). Cervical lymph nodes were noted in 22 patients (25%) and
supraclavicular lymphadenopathy was seen in 16 (18%). Sinus formation was
seen in 16 (18%) patients. 27 cases (30%) had fluctuating lymph nodes.
Four infants had disseminated infection. The majority (65%) of patients had
their symptoms starting within the first 2 months after BCG vaccination.
Forty-two (47%) infants had conservative observational management.
Anti-tuberculosis medications were commenced in 27 (30%). Surgical excision
was performed in 10 (11.5%) cases. All infants but one had complete recovery
by the end of the study period. BCG lymphadenitis is a potential complication
that necessitates an early recognition and implementing appropriate treatment
protocols. Complete healing of suppurative lymphadenitis after BCG vaccine can
be achieved using different treatment protocols.
