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The effect of local rifampicin instillation on the treatment of suppurative BCG lymphadenitis

Korean Journal of Pediatrics 2006;49(1):40-45.
Published online January 15, 2006.
The effect of local rifampicin instillation on the treatment of suppurative BCG lymphadenitis
Min Son Kim1, Dae Sun Jo1, Kang Mi Kyung2, Sang Jae Kim3, Jung Soo Kim4
1Department of Pediatrics, Medical School, Chonbuk National University, Jeonju
2Korean Institute of Tuberculosis, Seoul,
3International Union against Tuberculosis and Lung Disease, Seoul, Korea
4Department of Pediatrics, Medical School, Chonbuk National University, Jeonju
BCG 접종에 따른 화농성 림프절염의 rifampicin 국소투여 효과
김민선1, 조대선1, 강미경2, 김상재3, 김정수4
1전북대학교 의과대학 소아과학교실
2결핵연구원
3국제항결핵연맹
4전북대학교 의과대학 소아과학교실
Correspondence: 
Jung Soo Kim, Email: kimisp@moak.chonbuk.co.kr
Abstract
Purpose
: The purpose of this study was to evaluate the types of lymphadenitis after BCG vaccination and the effect of local rifampicin instillation on the treatment of suppurative BCG lymphadenitis.
Methods
: A total of 32 otherwise healthy infants with suppurative BCG lymphadenitis, who visited the Department of Pediatrics of Chonbuk National University Hospital, from March 2002 through June 2004, were enrolled in this study. They were treated with needle aspiration and local rifampicin instillation. We investigated the time the lymphadenitis took to be suppurative, accompanying clinical manifestations, and the treatment effects.
Results
: Of the 32 infants, 19 were male and 13 were female. They were full term babies and one preterm baby with a gestational age of 30 weeks. They received intradermal administration, with the BCG vaccine of Pasteur (French) strain mostly on the left deltoid area(96.9 percent). Regional lymphadenitis occurred in 1 to 11 months after BCG vaccination, mostly 1-5 months after vaccination (78.1 percent). Among the infants, 87.5 percent had unilocular lesion but 12.5 percent had more than one enlarged lymph node cares. Most of the lymphadenitis presented in the left axillary area(77.8 percent), and the left supuraclavicular area(11.1 percent). After one to three times of needle aspiration with rifampin instillation, all infants recovered completely without surgical excision or severe complication.
Conclusion
: The regional lymphadenitis is the most common complication in infants who receive intradermal BCG vaccination. This study supports that in suppurative BCG lymphadenitis the needle aspiration and local rifampicin instillation is very effective and can be a more economical treatment modality.
Key Words: BCG vaccine , Lymphadenitis , Treatment , Instillation , Drug , Rifampin


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