关键词: 卡介苗, 接种, 淋巴管炎, 异烟肼, 引流术

Abstract: Objective  To analyze the clinical signs and evaluate  the efficacy of local treatment for the strong reactions of 112 cases axillary lymph nodes caused by neonatal BCG vaccination.  Methods  The 112 cases of confirmed cases were given different local treatments including local fomentation, lesion needle aspiration, complete debridement and drainage with antituberculous drugs and the efficacy of the treatments were evaluated.  Results  1)The dictionary 112 cases were classified to 4 types: 13 cases presented with the proliferation scleroma, 41 cases with cheese necrosis, 47 cases with abscess rupture, and 11 cases with proliferation cheese necrosis which did not healed after surgery in other hospitals. 2)Needle aspiration specimens or pus were taken from 58 cases for acid-fast bacilli smear and culture examination at the first presentation，in which 18 cases were smear positive, 22 cases were culture positive. Among the 22 cases, 20 cases were mycobacterium bovis through the strain identification. 3) 13 cases with proliferation scleroma were given local fomentation 2-4 times a day. B-ultrasound after 4-8 weeks showed that nodular in 5 cases shrunk and liquid was seen in 8 cases. Cheese necrosis in 49(41+8) cases were given local needle aspiration, and then 10-20 mg(0.2-0.4 ml) INH were injected into the nodule once a week，combining with heating. The wound of 96 (47+49) cases with abscess rupture healed after 4-10 weeks, an average of 8 weeks through debridement, wound drainage, which were given isoniazid once a week. 7 cases from other hospitals whose wound did not heal after surgery were given drainage with isoniazid once a week, the wound healed after 4-12 weeks, on an average of 8 weeks. 4)After 6 month follow-up，there were no relapse cases occurred.  Conclusion  Abnormal reactions of the ipsilateral axillary lymph nodes would occur in a small number of infants and young children after neonatal BCG vaccination，most will eventually form a cold abscess and ulcerate. Local treatment have little trauma, less lesion, low risk and high cure rate than surgical resection, and it should be widely used in the future.

Key words: BCG vaccine, Vaccination, Lymphangitis, Isoniazid, Drainage