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Scrofula
Tuberculous adenitis
Scrofula is a tuberculosis infection of the lymph nodes in the neck.
Tuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
Causes
Scrofula is most often caused by the bacteria Mycobacterium tuberculosis .
It is usually caused by breathing in contaminated air.
Symptoms
Symptoms of scrofula are:
- Fevers (rare)
-
Painless
swelling of lymph nodes
in the neck and other areas of the body
Swelling of lymph nodes
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
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- Sweats
Exams and Tests
Tests to diagnose scrofula include:
- Biopsy of affected tissue
- Chest x-rays
- CT scan of the neck
- Cultures to check for the bacteria in tissue samples taken from the lymph nodes
- HIV blood test
-
PPD test
(also called TB test)
PPD test
The PPD skin test is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative.
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Treatment
When infection is caused by Mycobacterium tuberculosis , treatment usually involves 9 to 12 months of antibiotics. Several antibiotics need to be used at once. Common antibiotics for scrofula include:
- Ethambutol
- Isoniazid (INH)
- Pyrazinamide
- Rifampin
When infection is caused by another type of mycobacteria (which often occurs in children), treatment usually involves antibiotics such as:
- Rifampin
- Ethambutol
- Clarithromycin
Surgery is sometimes used first. It may also be used if the medicines are not working.
Outlook (Prognosis)
With treatment, people usually make a complete recovery.
Possible Complications
These complications may occur from this infection:
- Draining sore in the neck
- Scarring
When to Contact a Medical Professional
Call your health care provider if you or your child has a swelling or group of swellings in the neck. Scrofula can occur in children who have not been exposed to someone with tuberculosis.
Prevention
People who have been exposed to someone with tuberculosis of the lungs should have a PPD test.
References
Ellner JJ. Tuberculosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 332.
Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 251.
Review Date: 12/7/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
