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Scrofula

Definition:

Scrofula is a tuberculosis infection of the lymph nodes in the neck.



Alternative Names:

Tuberculous adenitis



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:



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)
  • Other tests for tuberculosis (TB)


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.

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