The BCG vaccination in a baby has festered: is it normal or a dangerous complication?

The first administration of the BCG vaccine is given to the child in the maternity hospital, just a few days after his birth.

The purpose of vaccination is to create a protective barrier to the development of tuberculosis. Often, after this procedure, parents note that the BCG vaccination has festered.

Such changes are not considered by doctors as a disease. This is a normal reaction of the body, but it should not be underestimated. The injection site must be constantly monitored.

What is the BCG vaccination?

BCG is a foreign abbreviation that stands for BCG - Bacillus Calmette (Bacillus Calmette-Guerin). Vaccination is included in the list of mandatory vaccinations, but not everyone has an idea of ​​what this drug is and what the purpose of its administration is.

The medication is designed to protect a person from tuberculosis. To make the drug, a live but very weakened strain of tuberculosis bacillus is used. It is not dangerous for the child, as it is grown in an artificial environment.

Among the main features of the vaccine are the following:

• used to prevent tuberculosis;
• is not intended to protect against infection, the infection in vaccinated people occurs in a latent form, protection is created for the disease to become open;
• prevents tuberculosis from becoming severe, when bones and joints are damaged, dangerous forms of infection of the lungs, tuberculous meningitis;
• helps reduce the incidence of morbidity in childhood.

What not to do

A cold abscess that develops normally does not require any treatment. Parents are strongly advised not to interfere with the process of formation and development of the wound. The injection site should not be:

• bandage;
• open;
• squeeze out pus;
• comb;
• treat with antibacterial drugs.

An antiseptic can destroy the tuberculosis bacillus, which will prevent the body from developing an immune response. Any mechanical damage can be dangerous. The likelihood of infection entering the wound increases, which leads to secondary suppuration and is accompanied by classic symptoms of an abscess.

It is advisable that the BCG vaccination is given on an empty stomach. Afterwards, you should not feed the baby for another half an hour. At the discretion of the physician, a sterile dry cloth can be placed at the injection site, which the parent removes independently after a while. This will help protect the wound from infection.

If there are people suffering from tuberculosis where the baby lives, he cannot return home after the vaccine is administered. This will become possible only after the patient is isolated. Its habitat will have to be disinfected. Limiting contact continues for a certain time, at least 6-8 weeks.

BCG is festering: is this normal?

An abscess that appears at the site of BCG in newborns is considered normal.

The introduction of the vaccine leads to the following changes:

1. A white spot appears on the skin, which disappears after half an hour.
2. The vaccination site turns red and swells. Similar symptoms are observed within three days.
3. No reactions have been observed for a month.
4. A month after vaccination, a papule appears, which transforms into an abscess.

The reaction to the vaccine in infants manifests itself slowly . The immune response is observed after one or two months. During this period, BCG begins to fester. Such changes are considered normal. The body reacts to the introduction of a foreign body under the skin.

The following external signs of abscess formation are noted:

• a formation shaped like a pimple, capsule or spot that protrudes above the skin;
• the size of the abscess reaches one centimeter;
• the injection site becomes bluish, brown, red or flesh-colored, and the presence of purulent contents is noted.

After a while, the contents of the abscess flow out, a crust forms, which disappears on its own. After six months, only a scar remains in place of the BCG.

How is the vaccine given?

According to WHO recommendations, the BCG vaccine is given in the forearm. A suitable place for vaccination is on the outside of the left arm. It is strictly forbidden to give an injection intramuscularly or subcutaneously; the liquid is injected into the skin. If for some reason an injection into the shoulder is not possible, the surface of the thigh is suitable.

Such vaccinations are permitted only with disposable syringes. The needle should be thin and have a beveled tip. First, the doctor has to tighten the skin on the desired area of ​​the arm. The liquid is introduced gradually so that the specialist can control the distribution of the vaccine.

If the BCG vaccination was administered correctly, a reaction appears at the injection site. A small whitish papule gradually appears on the surface of the skin, the diameter of which should not exceed 10 mm. Within half an hour it disappears when the liquid is absorbed and enters the body.

No other vaccinations are given at the same time as BCG. Therefore, if you plan to undergo other vaccinations, they will have to be postponed for some time.

What exactly causes pus to appear?

Rotting after BCG vaccination in a child at 2 months is a natural reaction to the vaccine. Such changes are not a cause for concern if the abscess is small and the accompanying symptoms are consistent. Sometimes an immune response is observed in the form of redness without pus, which is also considered normal.

This is how the reaction to the strain of infection that has entered the body is manifested. The syringe is inserted intradermally. This leads to inevitable dermatological changes.

Sometimes such symptoms are regarded as manifestations of BCG infection. This is a serious complication of vaccination, but it is worse when the wound does not fester. The vaccine does not have the desired effect.

Suppuration is caused by improper administration of the drug. This occurs if the vaccine was given subcutaneously, and not intradermally, as required by the instructions. In addition, unpleasant symptoms are observed when using a low-quality vaccine.

How should the suppuration end?

Regardless of the severity of the process, suppuration should end in the formation of a scar, which looks like a small depression in the skin of the upper third of the shoulder. The norm is for a scar to form within one year; if this does not happen, you should consult a pediatrician or family doctor. If the course is complicated, the process may result in the following phenomena:

• Lymphadenitis is inflammation of the lymph nodes when Mycobacterium tuberculosis penetrates them.
• The development of extensive skin lesions in the injection area may indicate the presence of immunodeficiency.
• The formation of large ulcerations indicates increased sensitivity of the body to the components of the vaccine - the causes of allergies are often congenital.
• Bone tuberculosis develops when the child’s immune system is not functioning properly.
• The development of a cold abscess occurs when the drug is administered incorrectly.
• The appearance of osteomyelitis with low quality vaccine.
• Formation of a keloid scar.
• A complete absence of a scar is observed when the vaccine is administered too deeply or when the immune system is strong, in which the influence of microorganisms is immediately suppressed.

When suppuration is not normal

Not in all cases the appearance of an abscess is considered normal. It should not exceed 1.5–2 cm in size.

The following changes are also of concern:

• pink or red halo;
• there is severe swelling around the abscess;
• ulcers form at the injection site;
• the appearance of a keloid scar is noted;
• axillary lymph nodes are enlarged.

If such symptoms appear, you should consult a doctor. Secondary infection and complications of vaccination cannot be ruled out.

Contraindications

Before vaccination, the child is examined. If there are any contraindications, it is prohibited to do BCG, otherwise the risk of complications and a poor reaction of the baby’s body increases. The list of prohibitions includes:

• the presence of HIV infection in the mother;
• prematurity;
• weight less than 2.5 kg;
• radiation therapy;
• acute illness;
• tumors;
• skin lesions;
• purulent-septic pathology;
• hemolytic disorders.

In older children, allergies, a questionable reaction to the Mantoux test, low immunity and frequent contact with a person suffering from tuberculosis also become obstacles to vaccination. Before administering the vaccine, an examination by a pediatrician is required.

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After the end of the acute period of allergy or active disease, you will have to wait a month before re-vaccination. At this time, the child requires special attention and at the first suspicion of infection or an abnormal process of abscess formation, it is necessary to urgently consult a doctor.

Is it necessary to treat the vaccination site?

When talking about what to do when suppuration appears, doctors unanimously repeat - do not take any measures.

It is strictly forbidden to treat the injection site with ointments, antiseptics and all kinds of solutions . When performing such manipulations, the body cannot cope with the introduced bacteria on its own and immunity is not properly developed. The pustule should be left alone. You need to wait for the immune reaction to complete.

Norm and deviations

What to do if the graft site begins to fester and is this a problem? In fact, such a reaction is normal; the appearance of a small wound indicates that the body is undergoing a period of formation of immunity to the introduced mycobacterium. The norm is the appearance of a small abscess up to one centimeter in size without severe complications such as inflammation of tissues and lymph nodes, elevated temperature.

Also considered normal

If the size of the ulcer is more than one centimeter, then this is a sign of increased sensitivity of the body to the vaccine or the presence of immunodeficiency in the child. Regardless of the cause, you should consult a doctor for further monitoring.

Also considered a deviation from the norm

Normally, the formation of immunity occurs in three stages:

• at the site of vaccination, redness of the tissues and their thickening are observed, this takes about 1-2 months;
• a small bubble with a whitish head appears, which becomes covered with a crust - it is at this time that the body’s local fight against mycobacteria occurs, and pus is the decay products of dead bacteria and lymphocytes;
• Scarring occurs, which indicates the development of immunity; in some cases, such a scar may be absent altogether, but this indicates unformed immunity or too deep administration of the vaccine.

Is it possible to squeeze pus out of a vaccine?

It is strictly forbidden to perform the following manipulations with the abscess:

• open, cut and pierce;
• picking, combing and squeezing;
• cover with a plaster and bandage;
• rub, press.

It is extremely important that the pus drains on its own. If the size of the abscess exceeds the permissible norms, and the skin around it becomes inflamed, you need to contact a medical facility. The doctor will open the purulent formation and prescribe proper treatment.

You cannot try to help the baby on your own and resort to pumping out pus. Such actions can lead to its accumulation in other places and the addition of a secondary infection.

Actions after opening a purulent capsule

If the papule bursts and pus comes out of it, there is no need to treat the wound with any antibacterial agents. All that parents have to do at this moment is to blot the affected area with gentle movements using a sterile napkin and temporarily cover the wound with a bandage. Otherwise, the baby will scratch it, which will increase the risk of infection.

After a short time, a crust forms on this place and the bandage can be removed.

What to do if the abscess bursts and the pus comes out?

Spontaneous opening of a purulent “bump” is a natural stage in the formation of specific immunity. Now the main task is to wait for the abscess to “clean itself.”

It is prohibited to speed up this process by squeezing out the contents inside the wound. When the pus comes out, the shoulder should be covered from the external environment with a sterile bandage and wait for its natural healing.

There is no need to panic, but if the abscess does not heal and swells, the discharge becomes more abundant and hyperemia is observed, then, most likely, something has gone wrong. In this case, the child needs qualified medical care, so any self-medication is inappropriate.

You cannot visit the pool during active discharge of pus.

Possible complications

The appearance of an abscess is considered a natural physiological process after BCG vaccination. It disappears on its own. No drastic measures need to be taken.

You should also not ignore purulent formation . He needs to be monitored and hygiene rules observed. It is unacceptable for dirt to get into the wound. Mechanical damage will also negatively affect the papule.

In the post-vaccination period, complications may occur. The doctor identifies the cause of such changes and then announces the prognosis.

The following pathological processes are observed:

• an increase in the size of the lymph nodes;
• addition of a secondary infection;
• formation of a red scar;
• statements;
• disseminated or persistent BCG infection;
• suppression of the immune system.

The pediatrician will be able to determine what is causing the abscess. Concomitant symptoms help to easily distinguish a local reaction to the vaccine from secondary infection and complications after immunization.

Individual intolerance

There are cases when a child after a BCG vaccination begins to feel unwell. Most often, the cause of this condition is an individual reaction to the administered drug or its components. Symptoms of this phenomenon may include:

1. Severe weakness, lethargy, apathy.
2. Loss of appetite.
3. Sleep disturbance.
4. A sharp increase in temperature.
5. Headache.
6. Joint pain.
7. Severe allergic reaction.
8. Hyperemia of the injection site and surrounding area.
9. Swelling over 3 cm.

In particular, this is why doctors recommend staying close to the clinic at least during the first half hour. As a rule, with individual intolerance, symptoms appear immediately.

If your baby exhibits any of the above symptoms after vaccination, you should definitely consult a doctor for advice. Firstly, a note will be made in the child’s card, secondly, the baby will be given first aid and, if necessary, treatment will be prescribed, thirdly, these symptoms are not always the result of intolerance, it is possible that the child’s vaccination coincided with the onset of a cold diseases, for example.