Local Rifampicin Instillation Therapy for Suppurative
Bacillus Calmette-Gu rin Lymphadenitis

Kim, Mee Jeong; Jang, Seong Hee; Ahn, Young Min; Kang, Mi Kyoung; Kim, Sang Jae

Original Article

Journal of the Korean Pediatric Society 2002;45(4):454-458.
Published online April 15, 2002.

Local Rifampicin Instillation Therapy for Suppurative Bacillus Calmette-Gu rin Lymphadenitis

Mee Jeong Kim¹, Seong Hee Jang¹, Young Min Ahn¹, Mi Kyoung Kang², Sang Jae Kim²

¹Department of Pediatrics, Kangnam General Hospital Public Co. Seoul, Korea
²The Korean National Tuberculosis Association, Seoul, Korea

BCG 접종에 의한 화농성 림프절염의 Rifampicin 국소 주입 요법

김미정^¹^, 장성희^¹^, 안영민^¹^, 강미경^²^, 김상재^²

^¹지방공사 강남병원 소아과
^²대한결핵협회 결핵연구원

Correspondence:
Seong Hee Jang, Email: jsh@kangnamhosp.or.kr

Abstract

Purpose
: Bacillus Calmette-Gu rin(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis.
Methods
: The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis.
Results
: Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt.
Conclusion
: Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.

Key Words: Suppurative BCG lymphadenitis, Local rifampicin instillation therapy