Summary
In this study we presented 92 cases with regional lymphadenitis (over 1 cm in diameter) which was caused by BCG vaccination generally performed a few days after birth. The patients were divided into four therapy groups. In group I, the lymphadenitis in 26 cases was excised totally by a surgical operation and they improved in a median period of four weeks (average: 4.4). No therapy was applied in 33 patients constituting group II and their periods of improvement were 28 weeks (average: 29.1). Sixteen cases in group III were given isoniazid (INH) 10 mg/kg for six months in addition to total surgical excision and their healing period was 4.5 weeks (average: 4). Seventeen cases in group IV were administered only INH for six months and the median improvement period was found to be 27 weeks (average: 28.2). The statistical differences in terms of the improvement periods between groups I and III, and groups II and IV were found to be insignificant (p>0.05) but these differences were significant between groups I and II, groups I and IV, groups II and III, and groups III and IV (p<0.05). These results show that spontaneous healing is possible. Total excision is the best therapy for BCG lymphadenitis in suppurative forms and INH has no effect in shortening the therapy period.
Zusammenfassung
Bei 92 Fällen von regionaler Lymphadenitis nach BCG-Impfung (Durchmesser mehr als 1 cm) wurden vier verschiedene Therapieformen geprüft. Bei chirurgischer Exstirpation der vergrößterten Lymphknoten (n=26) betrug die mediane Heilungszeit vier Wochen (Durchschnitt 4,4 Wochen); gegenüber dieser Gruppe I benötigte Gruppe II mit 33 Kindern, die keinerlei Therapie erhielten, eine erheblich längere Heilungszeit von median 28 (Durchschnitt 29,1) Wochen. In Gruppe III wurden 16 Kinder chirurgisch und zusätzlich sechs Monate lang mit IHN in einer Dosierung von 10 mg/kg täglich behandelt, die mediane Heilungszeit betrug in diesen Fällen 4,4 (Durchschnitt 4) Wochen. Bei Gruppe IV mit 17 Fällen wurde ausschließlich medikamentös mit INH behandelt; trotz der sechswöchigen Therapie vergingen median 27 (im Durchschnitt 28,8) Wochen bis zur Heilung. Zwischen den Gruppen I und III und II und IV fanden sich keine signifikanten Unterschiede (p>0,05); dagegen waren signifikante Unterschiede mit p<0,05 zwischen den Gruppen I und II, I und IV und II und III nachzuweisen. Spontane Heilung der BCG-Lymphadenitis erwies sich als möglich; bei suppurativen Formen ist die totale Exzision das beste Vorgehen. INH verkürzte die Heilungszeit nicht.
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Baki, A., Usta, S., Öncü, M. et al. Therapy of regional lymphadenitis following BCG vaccination. Infection 19, 414–416 (1991). https://doi.org/10.1007/BF01726452
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DOI: https://doi.org/10.1007/BF01726452