{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T19:07:48Z","timestamp":1770491268759,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The management strategy of Bacille Calmette-Gu\u00e9rin (BCG) vaccine-induced regional suppurative lymphadenitis in children is still controversial and more clinical studies are needed. We therefore present a surgical case series to explore the role of surgical management for this dilemma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>From January 2013 to June 2020, data from 65 patients diagnosed with BCG vaccine-induced regional suppurative lymphadenitis were retrospectively reviewed. Clinical characteristics, ultrasonographic findings, surgical procedures, perioperative management, and outcome were analyzed. The association between postoperative seroma and symptom duration, skin involvement, and postoperative hospital stay were compared using Yates's corrected Chi-square test and Student's t-test for statistical analysis. The follow-up period ranged from three to six months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 65 cases, the median age at presentation was 3.4\u00a0months. All patients were full-term with normal range of birth weight and received a BCG vaccination in the first 24\u00a0h of life. All patients underwent surgical excision of the abscess with the involved lymph node(s). Postoperative seroma formation was found in 20 patients and fine needle aspiration was needed. There was no significant association between postoperative seroma formation with symptom duration, skin involvement, and postoperative hospital stay. No oral anti-tubercular agents were given postoperatively. The mean length of postoperative hospital stay was 6.02\u2009\u00b1\u20091.62\u00a0days. Sixty-four cases (98.46%) received only one procedure and recovered. One patient required a second procedure due to postoperative sinus.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The present study showed that surgical excision of the abscess with involved lymph node(s) is one of the choices for BCG vaccine-induced suppurative lymphadenitis, but special attention should be paid to controlling the surgical indications. Intraoperative meticulous manipulation and postoperative care are crucial to achieve a good outcome.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06531-8","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T13:03:44Z","timestamp":1628687024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The role of surgical management of BCG vaccine-induced regional suppurative lymphadenitis in children: a 7\u00a0years' experience from one medical center"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0250-1875","authenticated-orcid":false,"given":"Chen","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minxiang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3994-6154","authenticated-orcid":false,"given":"Xiaoliang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyu","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoxiu","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xijie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bufeng","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0216-5602","authenticated-orcid":false,"given":"Lei","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3048-1357","authenticated-orcid":false,"given":"Tingliang","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,11]]},"reference":[{"key":"6531_CR1","first-page":"107","volume":"21","author":"A Lotte","year":"1984","unstructured":"Lotte A, Wasz-H\u00f6ckert O, Poisson N, Dumitrescu N, Verron M, Couvet E. BCG complications. Estimates of the risks among vaccinated subjects and statistical analysis of their main characteristics. Adv Tuberc Res. 1984;21:107\u201393.","journal-title":"Adv Tuberc Res."},{"issue":"1","key":"6531_CR2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1146\/annurev.publhealth.11.1.127","volume":"68","author":"JB Milstien","year":"1990","unstructured":"Milstien JB, Gibson JJ. Quality control of BCG vaccine by WHO: a review of factors that may influence vaccine effectiveness and safety. Bull World Health Organ. 1990;68(1):93\u2013108. https:\/\/doi.org\/10.1146\/annurev.publhealth.11.1.127.","journal-title":"Bull World Health Organ"},{"key":"6531_CR3","doi-asserted-by":"publisher","first-page":"CD008300","DOI":"10.1002\/14651858.CD008300.pub2","volume":"1","author":"CA Cuello-Garcia","year":"2013","unstructured":"Cuello-Garcia CA, Perez-Gaxiola G, Jimenez Gutierrez C. Treating BCG-induced disease in children. Cochrane Database Syst Rev. 2013;1:CD008300. https:\/\/doi.org\/10.1002\/14651858.CD008300.pub2.","journal-title":"Cochrane Database Syst Rev."},{"issue":"920","key":"6531_CR4","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1136\/pmj.78.920.327","volume":"78","author":"JS Goraya","year":"2002","unstructured":"Goraya JS, Virdi VS. Bacille Calmette-Guerin lymphadenitis. Postgrad Med J. 2002;78(920):327\u20139. https:\/\/doi.org\/10.1136\/pmj.78.920.327.","journal-title":"Postgrad Med J"},{"issue":"4","key":"6531_CR5","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1086\/499953","volume":"42","author":"AC Hesseling","year":"2006","unstructured":"Hesseling AC, Rabie H, Marais BJ, Manders M, Lips M, Schaaf HS, et al. Bacille Calmette-Guerin vaccine-induced disease in HIV-infected and HIV-uninfected children. Clin Infect Dis. 2006;42(4):548\u201358. https:\/\/doi.org\/10.1086\/499953.","journal-title":"Clin Infect Dis"},{"issue":"Suppl 2","key":"6531_CR6","doi-asserted-by":"publisher","first-page":"A64","DOI":"10.1136\/archdischild-2019-rcpch.153","volume":"104","author":"T Holliday","year":"2019","unstructured":"Holliday T, Seddon J, Whittaker E. G157(P) Adverse events in infants following bcg vaccination: preliminary results. Arch Dis Child. 2019;104(Suppl 2):A64. https:\/\/doi.org\/10.1136\/archdischild-2019-rcpch.153.","journal-title":"Arch Dis Child"},{"issue":"5","key":"6531_CR7","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/00006454-200205000-00026","volume":"21","author":"A Singla","year":"2002","unstructured":"Singla A, Singh S, Goraya JS, Radhika S, Sharma M. The natural course of nonsuppurative Calmette-Guerin bacillus lymphadenitis. Pediatr Infect Dis J. 2002;21(5):446\u20138. https:\/\/doi.org\/10.1097\/00006454-200205000-00026.","journal-title":"Pediatr Infect Dis J"},{"issue":"41","key":"6531_CR8","doi-asserted-by":"publisher","first-page":"5470","DOI":"10.1016\/j.vaccine.2015.07.103","volume":"33","author":"A Venkataraman","year":"2015","unstructured":"Venkataraman A, Yusuff M, Liebeschuetz S, Riddell A, Prendergast AJ. Management and outcome of Bacille Calmette-Guerin vaccine adverse reactions. Vaccine. 2015;33(41):5470\u20134. https:\/\/doi.org\/10.1016\/j.vaccine.2015.07.103.","journal-title":"Vaccine"},{"issue":"6","key":"6531_CR9","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1007\/BF01726452","volume":"19","author":"A Baki","year":"1991","unstructured":"Baki A, Oncu M, Usta S, Yildiz K, Karaguzel A. Therapy of regional lymphadenitis following BCG vaccination. Infection. 1991;19(6):414\u20136. https:\/\/doi.org\/10.1007\/BF01726452.","journal-title":"Infection"},{"issue":"5","key":"6531_CR10","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1007\/pl00012279","volume":"21","author":"P Hengster","year":"1997","unstructured":"Hengster P, S\u00f6lder B, Fille M, Menardi G. Surgical treatment of bacillus Calmette Gu\u00e9rin lymphadenitis. World J Surg. 1997;21(5):520\u20133. https:\/\/doi.org\/10.1007\/pl00012279.","journal-title":"World J Surg"},{"issue":"10","key":"6531_CR11","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.3969\/j.issn.1000-6621.2018.10.017","volume":"40","author":"AH Zhao","year":"2018","unstructured":"Zhao AH, Wang GZ, Fu LL, Xu M. Comparison of BCG vaccine quality standards of domestic and foreign. Chin J Antituberc. 2018;40(10):1125\u20138. https:\/\/doi.org\/10.3969\/j.issn.1000-6621.2018.10.017.","journal-title":"Chin J Antituberc."},{"issue":"2","key":"6531_CR12","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/00006454-199302000-00006","volume":"12","author":"PK Noah","year":"1993","unstructured":"Noah PK, Pande D, Johnson B, Ashley D. Evaluation of oral erythromycin and local isoniazid instillation therapy in infants with Bacillus Calmette-Guerin lymphadenitis and abscesses. Pediatr Infect Dis J. 1993;12(2):136\u20139. https:\/\/doi.org\/10.1097\/00006454-199302000-00006.","journal-title":"Pediatr Infect Dis J"},{"key":"6531_CR13","unstructured":"Wu W, Li B, Ni X, An Y. Clinic and curative effect analysis on 112 cases with strong reactions of lymph node caused by neonatal BCG vaccination. Chin J Antituberc, 2012; 34(4):241\u2013244.https:\/\/d.wanfangdata.com.cn\/periodical\/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjEwNjE2Eg96Z2ZsenoyMDEyMDQwMTAaCHJsZTdhNmVq"},{"issue":"3","key":"6531_CR14","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.medici.2016.05.001","volume":"52","author":"A Engelis","year":"2016","unstructured":"Engelis A, Kakar M, Meik\u0161\u0101ns R, Petersons A. BCG-SSI(\u00ae) vaccine-associated lymphadenitis: Incidence and management. Medicina (Kaunas). 2016;52(3):187\u201391. https:\/\/doi.org\/10.1016\/j.medici.2016.05.001.","journal-title":"Medicina (Kaunas)"},{"issue":"1","key":"6531_CR15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.5144\/0256-4947.2021.24","volume":"41","author":"BA Waili","year":"2021","unstructured":"Waili BA, Mufarajii NA, Hashmi SA, Ajmi AA, Sukaiti NA. Bacillus Calmette-Guerin vaccine-related complications in children in Oman. Ann Saudi Med. 2021;41(1):24\u201330. https:\/\/doi.org\/10.5144\/0256-4947.2021.24.","journal-title":"Ann Saudi Med"},{"issue":"2","key":"6531_CR16","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1093\/tropej\/fmt100","volume":"60","author":"M Daei Parizi","year":"2014","unstructured":"Daei Parizi M, Kardoust Parizi A, Izadipour S. Evaluating clinical course of BCG lymphadenitis and factors affect on it during a 5-year period in Kerman. Iran J Trop Pediatr. 2014;60(2):148\u201353. https:\/\/doi.org\/10.1093\/tropej\/fmt100.","journal-title":"Iran J Trop Pediatr"},{"issue":"7","key":"6531_CR17","first-page":"1120","volume":"68","author":"F Naumeri","year":"2018","unstructured":"Naumeri F, Khan MS, Rauf A, Imran S, Tahir M. Role of needle aspiration and surgical excision in management of suppurative Bacillus Calmette Guerin lymphadenitis. J Pak Med Assoc. 2018;68(7):1120\u20133 (PMID: 30317317).","journal-title":"J Pak Med Assoc"},{"issue":"4","key":"6531_CR18","first-page":"16","volume":"17","author":"Z Nazir","year":"2005","unstructured":"Nazir Z, Qazi SH. Bacillus Calmette-Guerin (BCG) lymphadenitis-changing trends and management. J Ayub Med Coll Abbottabad. 2005;17(4):16\u20138 (PMID: 16599027).","journal-title":"J Ayub Med Coll Abbottabad"},{"issue":"3","key":"6531_CR19","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/01.XPS.0000413172.23876.7d","volume":"8","author":"RH Hassan","year":"2012","unstructured":"Hassan RH, Aly AE, Kandil SM, Zaki M. Post-Bacillus Calmette-Gu\u00e9rin lymphadenitis in Egyptian children: an outbreak. Annals of Pediatric Surgery. 2012;8(3):69\u201373. https:\/\/doi.org\/10.1097\/01.XPS.0000413172.23876.7d.","journal-title":"Annals of Pediatric Surgery"},{"issue":"6","key":"6531_CR20","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/j.1442-200x.1991.tb02593.x","volume":"33","author":"S Caglayan","year":"1991","unstructured":"Caglayan S, Arikan A, Yaprak I, Aksoz K, Kansoy S. Management of suppuration in regional lymph nodes secondary to BCG vaccination. Acta Paediatr Jpn. 1991;33(6):699\u2013702. https:\/\/doi.org\/10.1111\/j.1442-200x.1991.tb02593.x.","journal-title":"Acta Paediatr Jpn"},{"issue":"11","key":"6531_CR21","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1001\/archpedi.1987.04460110083029","volume":"141","author":"S Caglayan","year":"1987","unstructured":"Caglayan S, Yegin O, Kayran K, Timocin N, Kasirga E, Gun M. Is medical therapy effective for regional lymphadenitis following BCG vaccination? Am J Dis Child. 1987;141(11):1213\u20134. https:\/\/doi.org\/10.1001\/archpedi.1987.04460110083029.","journal-title":"Am J Dis Child"},{"issue":"1","key":"6531_CR22","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/S0248-8663(01)00522-7","volume":"92","author":"M Nicol","year":"2002","unstructured":"Nicol M, Eley B, Kibel M, Hussey G. Intradermal BCG vaccination\u2013adverse reactions and their management. S Afr Med J. 2002;92(1):39\u201342. https:\/\/doi.org\/10.1016\/S0248-8663(01)00522-7.","journal-title":"S Afr Med J"},{"issue":"6","key":"6531_CR23","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1111\/iwj.12755","volume":"14","author":"SO Baek","year":"2017","unstructured":"Baek SO, Ko HS, Han HH. BCG vaccination-induced suppurative lymphadenitis: four signs to pay attention to. Int Wound J. 2017;14(6):1385\u20137. https:\/\/doi.org\/10.1111\/iwj.12755.","journal-title":"Int Wound J"},{"issue":"5","key":"6531_CR24","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1136\/adc.71.5.446","volume":"71","author":"SA Banani","year":"1994","unstructured":"Banani SA, Alborzi A. Needle aspiration for suppurative post-BCG adenitis. Arch Dis Child. 1994;71(5):446\u20137. https:\/\/doi.org\/10.1136\/adc.71.5.446.","journal-title":"Arch Dis Child"},{"issue":"12","key":"6531_CR25","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1136\/adc.57.12.952","volume":"57","author":"PK Tam","year":"1982","unstructured":"Tam PK, Stroebel AB, Saing H, Lau JT, Ong GB. Caseating regional lymphadenitis complicating BCG vaccination: a report of 6 cases. Arch Dis Child. 1982;57(12):952\u20134. https:\/\/doi.org\/10.1136\/adc.57.12.952.","journal-title":"Arch Dis Child"},{"issue":"7","key":"6531_CR26","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1136\/adc.2005.078972","volume":"91","author":"T Bolger","year":"2006","unstructured":"Bolger T, O\u2019Connell M, Menon A, Butler K. Complications associated with the bacille Calmette-Gu\u00e9rin vaccination in Ireland. Arch Dis Child. 2006;91(7):594\u20137. https:\/\/doi.org\/10.1136\/adc.2005.078972.","journal-title":"Arch Dis Child"},{"issue":"2","key":"6531_CR27","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.ijpam.2015.05.003","volume":"2","author":"N Elsidig","year":"2015","unstructured":"Elsidig N, Alshahrani D, Alshehri M, Alzahrani M, Alhajjar S, Aljummah S, et al. Bacillus Calmette-Guerin vaccine related lymphadenitis in children: Management guidelines endorsed by the Saudi Pediatric Infectious Diseases Society (SPIDS). Int J Pediatr Adolesc Med. 2015;2(2):89\u201395. https:\/\/doi.org\/10.1016\/j.ijpam.2015.05.003.","journal-title":"Int J Pediatr Adolesc Med"},{"issue":"28","key":"6531_CR28","doi-asserted-by":"publisher","first-page":"4046","DOI":"10.1016\/j.vaccine.2018.05.098","volume":"36","author":"R Rermruay","year":"2018","unstructured":"Rermruay R, Rungmaitree S, Chatpornvorarux S, Brukesawan C, Wittawatmongkol O, Lapphra K, et al. Clinical features and outcomes of Bacille Calmette-Gu\u00e9rin (BCG)-induced diseases following neonatal BCG Tokyo-172 strain immunization. Vaccine. 2018;36(28):4046\u201353. https:\/\/doi.org\/10.1016\/j.vaccine.2018.05.098.","journal-title":"Vaccine"},{"issue":"3","key":"6531_CR29","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1136\/archdischild-2013-304457","volume":"99","author":"A Riordan","year":"2014","unstructured":"Riordan A, Cole T, Broomfield C. Fifteen-minute consultation: Bacillus Calmette-Gu\u00e9rin abscess and lymphadenitis. Arch Dis Child Educ Pract Ed. 2014;99(3):87\u20139. https:\/\/doi.org\/10.1136\/archdischild-2013-304457.","journal-title":"Arch Dis Child Educ Pract Ed"},{"issue":"2","key":"6531_CR30","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1002\/dc.24613","volume":"49","author":"A Jain","year":"2021","unstructured":"Jain A, Gupta S, Gupta P, Rohilla M, Gupta N, Srinivasan R, Rajwanshi A, Dey P. Fine-needle aspiration cytology of Bacille Calmette-Guerin adenitis: a perplexing distinct clinical entity. Diagn Cytopathol. 2021;49(2):226\u201331. https:\/\/doi.org\/10.1002\/dc.24613.","journal-title":"Diagn Cytopathol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06531-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06531-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06531-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T13:03:55Z","timestamp":1628687035000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06531-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,11]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6531"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06531-8","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,11]]},"assertion":[{"value":"4 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from the parents\/legal guardian(s) of all children involved in the study. All methods of the study protocol were approved by the Ethics Committee of Binzhou Medical University Hospital in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"801"}}