Diagnostic Dilemma - Pediatric Oncall
Post BCG axillary lymphadenitis
A 10 months old girl presented with left sided axillary lymphadenitis. There is no other lymphnode enlargement. Chest is clear and there is no fever. These lymph nodes burst spontaneously with caseous material so there is possibility of post BCG lymphadenitis.
Answers of this discussion
Author :- asima rubina on 26 January 2012.
Answer :- yes rifampicin inh an pyrazinamie

Author :- lalji vaghjiyani on 28 January 2012.
Answer :- surgically remove lymphnode no akt required

Author :- gotur ramulu on 29 January 2012.
Answer :- INH{isoniazide}should be given for 6 months.

Author :- K C Tamaria on 29 January 2012.
Answer :- Since multiple lymph nodes involved, child needs ATT to be put on 2HRZplus4HR. HIV shall be ruled out.

Author :- kamaraj kandaswamy on 29 January 2012.
Answer :- inh for 6months

Author :- Jasbir S Chugh on 29 January 2012.
Answer :- INH and Erythromycin for 4-6 weeks. Surgical excision of remaining nodes if fluctuant.

Author :- manik sarpe on 29 January 2012.
Answer :- should start with 2 drugs for 3 months.{inhplusriphmpicin}. do montoux test after 3 months treatment. if negative stop mediciations. if positive montoux test continue treatment for full course of 6 months.

Author :- anil prasad on 29 January 2012.
Answer :- no medication required

Author :- Azeem Walele on 30 January 2012.
Answer :- Should the child be HIV uninfected, no treatment is necessary or at the most further curettage or excision is needed. One should exclude disseminated BCG first. If the child is HIV infected or BCG IRIS is suspected or there are features of disseminated BCG then treatment is required {INH, Rifampicin, PZA, Ethambutol, Ciprofloxacin or Ofloxacin} for 9 months. Exclude Tuberculosis. Monitor for drug toxicity and report as an EPI adverse event. Regards Azeem Walele South Africa

Author :- KKR WARIYAR on 30 January 2012.
Answer :- Single drug INAH for 3 months

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