Surgical Management of Bacille Calmette-Guérin Vaccine-related Regional Lymphadenitis in Infants

Abstract

BackgroundThe management of Bacille Calmette-Guérin (BCG) vaccine-related regional lymphadenitis in infants is still controversial. We present the results of surgical treatment for this condition.AimTo report our experience in the surgical management in infants with BCG vaccine-related regional lymphadenitis.ResultsFrom January 2013 to June 2020, 65 patients with BCG vaccine-related regional lymphadenitis were retrospectively reviewed. The patients included 55 boys and ten girls. Median age was 3.35 months (5.83±8.17, IQR 3.35-5.1). The infants were all full-term with normal birth weight and received vaccination in the first 24 h of life. All patients underwent surgical excision of the abscess and involved regional lymph nodes, and tolerated anesthesia and the surgical procedure well. Postoperative seroma occurred in 20 patients (20/65). The effusion was aspirated with a fine needle. Sixty-four patients recovered uneventfully. No anti-tuberculosis drugs were given postoperatively. Postoperative abscess recurred in one case and re-operation was required one year later. Postoperative follow-up of three to 12 months showed that all patients had a good outcome.ConclusionSurgical management of infantile BCG vaccine-related lymphadenitis is safe and effective with a low recurrence rate and few complications. Surgical intervention shortened the treatment period and avoided the use of anti-tuberculosis drugs. Surgeons should follow the natural course of this disease and be cautious in choosing surgical treatment.