Clinical characteristics and choices of treatment for lymphadenitis after BCG vaccination in infants

doi:10.3969/j.issn.2096-8493.2020.01.016

Abstract

Abstract:

BCG vaccination is an effective and safe measure to prevent tuberculosis. Although its adverse effect rate is very low, we still need to pay attention to prevention and management of BCG-related lymphadenitis in infants for which there are still some puzzles in diagnosis and treatment. In this paper, we reviewed latest updated literature and focused on clinical characteristics and treatment choices of BCG-related lymphadenitis in order to provide available reference for its prevention and proper treatment.

Key words: BCG vaccine, Vaccination, Lymphadenitis, Disease attributes, Surgical procedures, Combined modality therapy

LIU Chen, XU Xiao-liang, FU Ting-liang. Clinical characteristics and choices of treatment for lymphadenitis after BCG vaccination in infants[J]. Journal of Tuberculosis and Lung Disease , 2020, 1(1): 78-81. doi: 10.3969/j.issn.2096-8493.2020.01.016

References 39

[1]	Baek SO, Ko HS, Han HH. BCG vaccination-induced suppurative lymphadenitis: four signs to pay attention to. Int Wound J, 2017,14(6):1385-1387. doi: 10.1111/iwj.12755. doi: 10.1111/iwj.12755 URL pmid: 28425207
[2]	张晓曙, 安婧, 李慧. 接种卡介苗后淋巴结炎综述. 中国疫苗和免疫, 2013,19(6):550-555.
[3]	白庆瑞, 胡家瑜, 刘捷宸, 等. 上海市2007—2017年卡介苗疑似预防接种异常反应监测分析. 中国疫苗和免疫, 2019,25(1):76-82.
[4]	郭伟, 徐勇胜, 万莉雅. 卡介苗相关性淋巴结炎. 中华实用儿科临床杂志, 2019,34(9):649-651. doi: 10.3760/cma.j.issn.2095-428X.2019.09.003.
[5]	刘志光. 接种卡介苗后淋巴结炎及其处理对策的研究现状. 医药前沿, 2017,7(13):372-373. doi: 10.3969/j.issn.2095-1752.2017.13.318.
[6]	Rermruay R, Rungmaitree S, Chatpornvorarux S, et al. Clinical features and outcomes of Bacille Calmette-Guérin (BCG)-induced diseases following neonatal BCG Tokyo-172 strain immunization. Vaccine, 2018,36(28):4046-4053. doi: 10.1016/j.vaccine.2018.05.098. doi: 10.1016/j.vaccine.2018.05.098 URL pmid: 29859799
[7]	Venkataraman A, Yusuff A, Liebeschuetz S, et al. Management and outcome of Bacille Calmette-Guérin vaccine adverse reactions. Vaccine, 2015,33(41):5470-5474. doi: 10.1016/j.vaccine.2015.07.103. doi: 10.1016/j.vaccine.2015.07.103 URL pmid: 26275478
[8]	Nuttall JJ, Davies MA, Hussey GD, et al. Bacillus Calmette-Guérin (BCG) vaccine-induced complications in children treated with highly active antiretroviral therapy. Int J Infect Dis, 2008,12(6):e99-105. doi: 10.1016/j.ijid.2008.06.014. doi: 10.1016/j.ijid.2008.06.014 URL pmid: 18799339
[9]	Kusuhara K, Ohga S, Hoshina T, et al. Disseminated Bacillus Calmette-Guérin lymphadenitis in a patient with gp91phox-chronic granulomatous disease 25 years after vaccination. Eur J Pediatr, 2009,168(6):745-747. doi: 10.1007/s00431-008-0824-9. doi: 10.1007/s00431-008-0824-9 URL
[10]	Takeda K, Kawai T, Nakazawa Y, et al. Augmentation of antitubercular therapy with IFN gamma in a patient with dominant partial IFN gamma receptor 1 deficiency. Clin Immunol, 2014,151(1):25-28. doi: 10.1016/j.clim.2014.01.004. doi: 10.1016/j.clim.2014.01.004 URL
[11]	Hesseling AC, Johnson LF, Jaspan H, et al. Disseminated bacille Calmette-Guérin disease in HIV-infected South African infants. Bull World Health Organ, 2009,87(7):505-511. doi: 10.2471/blt.08.055657. doi: 10.2471/blt.08.055657 URL pmid: 19649364
[12]	Vera JH, Hill SC, Rubinstein L. Bacille Calmette-Guérin disease following Bacille Calmette-Guérin vaccination of an HIV-infected health-care worker. Int J STD AIDS, 2012,23(7):e1-2. doi: 10.1258/ijsa.2009.009393. doi: 10.1258/ijsa.2009.009393 URL pmid: 22844017
[13]	陈黎, 岳冀, 周萍. 卡介苗病2例报告及相关文献复习. 临床肺科杂志, 2012,17(12):2317-2318.doi: 10.3969/j.issn.1009-6663.2012.12.100.
[14]	Dommergues MA, de La Rocque F, Guy C, et al. Local and regional adverse reactions to BCG-SSI vaccination: a 12-month cohort follow-up study. Vaccine, 2009,27(50):6967-6973. doi: 10.1016/j.vaccine.2009.09.073. doi: 10.1016/j.vaccine.2009.09.073 URL
[15]	Hengster P, Sölder B, Fille M, et al. Surgical treatment of Bacillus Calmette Guérin lymphadenitis. World J Surg, 1997,21(5):520-523. doi: 10.1007/pl00012279. doi: 10.1007/pl00012279 URL pmid: 9204741
[16]	肖东, 陈子民, 李苏伊. 手术治疗卡介苗反应性淋巴结炎57例疗效观察. 临床小儿外科杂志, 2010,9(5):356-357. doi: 10.3969/j.issn.1671-6353.2010.05.013.
[17]	Bukhari E, Alzahrani M, Alsubaie S, et al. Bacillus Calmette-Guérin lymphadenitis: a 6-year experience in two Saudi hospitals. Indian J pathol microbiol, 2012,55(2):202-205. doi: 10.4103/0377-4929.97869. doi: 10.4103/0377-4929.97869 URL pmid: 22771644
[18]	戴玉玲. 婴儿接种卡介苗致淋巴结炎15例临床分析. 现代中西医结合杂志, 2008,17(26):4147. doi: 10.3969/j.issn.1008-8849.2008.26.074.
[19]	武文清, 李波, 倪新兰, 等. 112例新生儿接种卡介苗引发淋巴结强反应的临床表现及疗效分析. 中国防痨杂志, 2012,34(4):241-244.
[20]	彭小旅, 董琦, 林海, 等. 婴幼儿卡介苗性腋窝淋巴结炎的外科治疗. 广东医学, 2009,30(11):1708-1709. doi: CNKI:SUN:GAYX.0.2009-11-061.
[21]	张兰, 张文同, 刘希杰, 等. 婴儿卡介苗接种后腋窝淋巴结炎的外科治疗. 中国现代普通外科进展, 2014,17(9):732-734. doi: 10.3969/j.issn.1009-9905.2014.09.020.
[22]	党昶永, 殷书平, 樊保平. 卡介苗淋巴结炎的临床表现、诱发因素及防治. 药物不良反应杂志, 2006,8(6):433-436. doi: 10.3969/j.issn.1008-5734.2006.06.010.
[23]	许俊, 倪正义, 周密. 婴幼儿卡介苗性淋巴结炎的外科治疗. 实用医学杂志, 2011,27(13):2395-2396. doi: CNKI:SUN:SYYZ.0.2011-13-040.
[24]	谭士勇, 王松楠. 卡介苗注射后引起腋下反应性淋巴结炎诊断及外科治疗. 中国社区医师(医学专业), 2010,12(27):67. doi: 10.3969/j.issn.1007-614x.2010.27.065.
[25]	冯永波, 金立民, 杨帆. 小儿卡介苗接种引起淋巴结异常反应231例诊断分析. 中国妇幼保健, 2008 (31):4425-4426. doi: CNKI:SUN:ZFYB.0.2008-31-027.
[26]	吴鹏, 鲁莹. 婴幼儿左腋下无痛性淋巴结肿大的病理特点研究. 吉林医学, 2011,32(19):3976.doi: 10.3969/j.issn.1004-0412.2011.19.083.
[27]	陈晓红, 阮琰, 林伟, 等. 全身播散性BCG感染1例. 中国防痨杂志, 2008,30(4):362-363.
[28]	Lotte A, Wasz Höckert O, Poisson N, et al. BCG complications. Estimates of the risks among vaccinated subjects and statistical analysis of their main characteristics. Adv Tuberc Res, 1984,21:107-193. URL pmid: 6475644
[29]	Elsidig N, Alshahrani D, Alshehri M, et al. Bacillus Calmette-Guérin vaccine related lymphadenitis in children: Management guidelines endorsed by the Saudi Pediatric Infectious Diseases Society (SPIDS). Int J Pediatr Adolesc Med, 2015,2(2):89-95. doi: 10.1016/j.ijpam.2015.05.003. doi: 10.1016/j.ijpam.2015.05.003 URL pmid: 30805444
[30]	李惠民, 赵顺英, 贺建新, 等. 播散性卡介苗感染18例分析. 中华儿科杂志, 2010,48(1):65-68. doi: 10.3760/cma.j.issn.0578-1310.2010.01.016.
[31]	夏露, 卢水华, 李锋. 母牛分枝杆菌菌苗治疗卡介苗反应性淋巴结炎临床分析. 中国防痨杂志, 2016,38(3):189-192. doi: 10.3969/j.issn.1000-6621.2016.03.007. doi: 10.3969/j.issn.1000-6621.2016.03.007 URL
[32]	Caglayan S, Yegin O, Kayran K, et al. Is medical therapy effective for regional lymphadenitis following BCG vaccination? Am J Dis Child, 1987,141(11):1213-1214.doi: 10.1001/archpedi.1987.04460110083029. URL pmid: 3673975
[33]	Goraya JS, Virdi VS. Bacille Calmette-Guérin lymphadenitis. Postgrad Med J, 2002,78(920):327-329. doi: 10.1136/pmj.78.920.327. doi: 10.1136/pmj.78.920.327 URL pmid: 12151684
[34]	Aoki Y, Kitazawa K, Tanese S. Unusual wound healing following suppurative BCG lymphadenitis [J/OL]. BMJ case Rep, 2018[2020-03-01]. https://casereports.bmj.com/content/2018/bcr-2018-225652.doi: 10.1136/bcr-2018-225652.
[35]	Naumeri F, Khan MS, Rauf A, et al. Role of needle aspiration and surgical excision in management of suppurative Bacillus Calmette-Guérin lymphadenitis. J Pak Med Assoc, 2018,68(7):1120-1123. URL pmid: 30317317
[36]	Tam PK, Stroebel AB, Saing H, et al. Caseating regional lymphadenitis complicating BCG vaccination: a report of 6 cases. Arch Dis Child, 1982,57(12):952-954. doi: 10.1136/adc.57.12.952. doi: 10.1136/adc.57.12.952 URL pmid: 7181528
[37]	Al Salem AH, Kothari MR, AlHani HM, et al. Safety of intradermal Bacillus Calmette-Guérin vaccine for neonates in Eastern Saudi Arabia. Saudi Med J, 2012. 33(2):172-176. URL pmid: 22327758
[38]	Lee TT, Simpson E, Malecky G, et al. Active BCG mycobacterial infection of lymph nodes following vaccination in two paediatric patients: is surgery indicated? Aust N Z J Surg, 2000,70(12):902-904. doi: 10.1046/j.1440-1622.2000.01980.x. doi: 10.1046/j.1440-1622.2000.01980.x URL pmid: 11167583
[39]	Engelis A, Kakar M, Meikšāns R, et al. BCG-SSI((R)) vaccine-associated lymphadenitis: Incidence and management. Medicina (Kaunas), 2016,52(3):187-191. doi: 10.1016/j.medici.2016.05.001.