Abstract
BCG is extensively used in the world for the prevention of tuberculosis. Although Japanese strain of BCG(Tokyo 172) has been considered to be less virulent than those used in other countries, cases with BCG complications have been increasingly reported in Japan. 19 patients with lymphadenitis or granuloma after BCG vaccination were treated in our hospital. The ages vaccinated were varied from 2 weeks to 16 months. Lesions were noticed 1 week to 16 months after vaccination, most of which were noticed less than 2 months. Axillar lymph nodes were involved in 14 patients, upper arm in 4, and supraclavicular region in 4(including 3 with axillar lesion). In 11 patients lesions were resected and diagnosed histopathologically as tuberculous lymphadenitis or tuberculous granuloma. Acid-fast bacilli were isolated from only 2 lesions out of 12 examined. In early cases, surgical removal of these lesions were indicated to assess the pathological diagnosis, followed by antituberculosis chemotherapy. After those experiences, some lesions were placed upon a strict observation and spontaneous decrease in size was observed without any chemotherapy. Only lesions which become fluctuant or suppurated in the course of observation were resected and followed by antituberculosis chemotherapy. According to these clinical and pathological resection with antituberculosis chemotherapy should be performed in a limited manner only when(1) any signs of generalized BCG infection are noticed, or(2) lesions become fluctuant or suppurate.
