Forum for Nordic Dermato-Venereology No 3, 2019 Telemedicine | Page 19

Luit Penninga, Anne Kathrine Lorentzen , Carsten Sauer Mikkelsen – Lymphadenitis in a Greenlandic Inuit Boy after BCG-vaccination
praclavicular or cervical lymph node enlargement (5). The
primary diagnostic modality is ultrasonography (5). Computed
tomography can also be used, but is not recommended as it
exposes the child to radiation (5). In our patient, ultrasonography showed no fluid collection,
and this case of non-suppurative lymphadenitis was treated
conservatively with good results.
Two forms of BCG lymphadenitis can occur; simple or
non-suppurative lymphadenitis, and suppurative lymph­
adenitis. In non-suppurative lymphadenitis, there is no fluid
collection, and the condition is best treated conservatively.
Spontaneous regression usually occurs over a period of sev-
eral weeks or months (3). Suppurative BCG lymphadenitis is
characterized by the development of a fluid collection in the
swelling, with erythema and oedema of the overlying skin.
Suppurative lymphadenitis resolves through spontaneous per-
foration and sinus formation, followed by secondary closure of
the sinus by scar tissue. Suppurative BCG lymphadenitis can
be treated by aspiration with a needle to accelerate resolution
and prevent spontaneous perforation and sinus formation.
Surgical excision is rare and should only be applied in cases
where needle aspiration has failed. R eferences
Forum for Nord Derm Ven 2019, Vol. 24, No. 4
1. Birch E, Andersson M, Koch A, Stenz F, Søborg B. Ten years of
tuberculosis intervention in Greenland - Has it prevented cases
of childhood tuberculosis? Int J Circumpolar Health 2014; 73.
DOI:10.3402/ijch.v73.24843.
2. Søborg C, Søborg B, Poulsen S, Pallisgaard G, Thybo S, Bauer J.
Doubling of the tuberculosis incidence in Greenland over an
8-year period (1990–1997). Int J Tuberc Lung Dis 2001; 5: 257–265.
3. Goraya JS, Virdi VS. Bacille Calmette-Guérin lymphadenitis. Post-
grad Med J 2002; 78: 327–329.
4. Al-Salem AH, Kothari MR, AlHani HM, Oquaish MM, Khogeer
SS, Desouky MS. Safety of intradermal Bacillus Calmette-Guerin
vaccine for neonates in Eastern Saudi Arabia. Saudi Med J 2012;
33: 172–176.
5. Baek SO, Ko HS, Han HH. BCG vaccination-induced suppurative
lymphadenitis: four signs to pay attention to. Int Wound J 2017;
14: 1385–1387.
T heme I ssue : T eledermatology
103