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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.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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