Bacille Calmette-Guérin (BCG)
lymphadenitis is the most common complication of BCG vaccination. Two forms of BCG
lymphadenitis can be recognised in its natural course-simple or non-suppurative
lymphadenitis, which usually regresses spontaneously over a period of few weeks, and suppurative BCG
lymphadenitis distinguished by the development of fluctuations in the swelling, with
erythema and oedema of overlying skin. Healing in suppurative glands occurs through
spontaneous perforation and sinus formation, followed by closure of the sinus by cicatrisation. Non-suppurative BCG
lymphadenitis is best managed with expectant follow ups only, because medical treatment with
erythromycin or antituberculous drugs do not hasten the regression or prevent development of
suppuration. Suppurative BCG
lymphadenitis may be treated by needle aspiration to hasten resolution and prevent
spontaneous perforation and sinus formation. Surgical excision is rarely needed and is meant for cases of failed needle aspiration or for draining BCG nodes.