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Lymphadenitis following intradermal BCG vaccination

Korean Journal of Pediatrics 2006;49(1):46-50.
Published online January 15, 2006.
Lymphadenitis following intradermal BCG vaccination
Hey Sung Baek, Ji Young Chang, Su Ji Moon, Sung Hee Oh
Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
피내용 BCG 접종 후 발생한 국소 림프절염
백혜성, 장지영, 문수지, 오성희
한양대학교 의과대학 소아과학교실
Correspondence: 
Sung Hee Oh, Email: sungheeo@hayang.ac.kr
Abstract
Purpose
: Intradermal BCG vaccine has not well been accepted by pediatric practitioners due to BCG lymphadenitis. Therefore, this study was undertaken to find out the incidence of lymphadenitis following intradermal BCG vaccination and its clinical outcome.
Methods
: One thousand and fifty infants, who received intradermal BCG(French 1173 P2, Korea Tuberculosis Association) vaccination in the Well Baby Clinic of Hanyang University Hospital from July 2001 to January 2004, were included in the study. Severe local reactions at the injection site and any mass noted on surrounding areas were reported to, and evaluated by, pediatricians. Surgical procedures, either surgical resection or needle aspiration, were recommended when lymph nodes progressed to suppurate without regression.
Results
: Twenty infants(1.9 percent) developed lymphadenitis 2 to 8 months following vaccination. The incidence of BCG lymphadenitis was significantly higher in infants born with intrauterine period of <38 weeks and birth weight of <2,700 g. The lymph nodes became suppurative in 7/17 infants (41.2 percent) and four infants required surgical procedures with which the rate for the requirement of surgical procedures among intradermal BCG vaccinnes approximated to be 0.45 percent. There was no correlation between the size of lymph nodes and suppuration, however surgical procedures were required significantly more often for lymph nodes of greater than 3 cm in diameter.
Conclusion
: The incidence of BCG lymphadenitis following intradermal BCG(French 1173 P2, Korea Tuberculosis Association) vaccinations would be more than 1.9 percent, when considering cases of lymphadenits not reported. More efforts need to be paid to decrease the incidence of BCG lymphadenitis in order to promote intradermal BCG vaccination in Korea.
Key Words: BCG vaccine , Lymphadenitis , Vaccination , Tuberculosis


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