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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

BCG-SSI® vaccine-associated lymphadenitis: Incidence and management

Department of Pediatric Surgery, Riga Stradins University, Riga, Latvia
Department of Pediatric Surgery, University Children's Hospital, Riga, Latvia
Author to whom correspondence should be addressed.
Medicina 2016, 52(3), 187-191;
Received: 29 May 2015 / Revised: 29 February 2016 / Accepted: 9 May 2016 / Published: 30 May 2016
Background and objective: There is a high incidence of childhood tuberculosis in Latvia, including children aged less than 1 year, while BCG-associated lymphadenitis is one of the most frequent adverse events requiring surgical treatment. The aim of this study was to analyze the incidence of purulent BCG adenitis through-out the population of Latvia after the introduction of BCG-SSI® vaccine and to evaluate the treatment results.
Material and methods: The study included 194 patients. All patients had received the BCGSSI ® vaccine during the first week of life routinely or at a later time according to the indications. The indications for surgical treatment were lymph node destruction also affecting the skin. All patients in this study received surgical treatment – the affected lymph node extirpation.
Results: The mean age of the patients was 5.12 0.96 months. A total of 172 patients had purulent axillar lymphadenitis, 14 had purulent supraclavicular lymphadenitis, 8 patients had lymphadenitis at both localizations. During the whole study period the incidence of BCG adenitis varied from 0.02% to 0.36%, while the mean rate was 0.11% 0.08% from 184,068 vaccinated children during the study period. We observed an increasing trend in the incidence of BCG lymphadenitis during the study period. The primary and complete healing rate at the end of period was 99.5% (n = 193) following an affected lymph node extirpation. The mean hospitalization time after the operation was 3.71 0.18 days.
Conclusions: The incidence of BCG-SSI® vaccine associated purulent lymphadenitis varied widely with an increasing trend, followed by the return to the product characteristic limits. Indications for the surgical treatment should not be changed. Extirpation of the purulent BCG adenitis is a safe treatment method and leads to the primary wound healing in the majority of cases.
Keywords: BCG-SSI® vaccine; Purulent BCG adenitis; Lymphadenitis; Complications BCG-SSI® vaccine; Purulent BCG adenitis; Lymphadenitis; Complications
MDPI and ACS Style

Engelis, A.; Kakar, M.; Meikšāns, R.; Petersons, A. BCG-SSI® vaccine-associated lymphadenitis: Incidence and management. Medicina 2016, 52, 187-191.

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