 Scrofula
Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Expectations (prognosis) Complications Calling your health care provider Prevention References DefinitionScrofula is a tuberculous infection of the lymph nodes in the neck. Alternative NamesTuberculous adenitis Causes, incidence, and risk factorsScrofula in adults is most often caused by the bacteria Mycobacterium tuberculosis. In children, can also be caused by Mycobacterium scrofulaceum or Mycobacterium avium. Infection with mycobacteria is usually caused by breathing in air that is contaminated by these organisms. SymptomsSigns and testsTests 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
- TB tine or PPD test
- Quantiferon gold blood test
TreatmentWhen infection is caused by Mycobacterium tuberculosis, treatment usually involves 9 - 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 bacteria (which often occurs in children), therapy usually involves antibiotics such as rifampin, ethambutol, and clarithromycin. Surgery is sometimes used as initial treatment, depending on circumstances. It may also be used if medications are not working on the infection. Expectations (prognosis)With treatment, patients usually make a complete recovery. Complications- Draining sore in the neck
- Scarring
Calling your health care providerCall your health care provider if 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. PreventionPeople who have been exposed to someone with tuberculosis of the lungs should have a PPD test. ReferencesPasternack MS, Swartz MN. Lymphadenitis and lymphangitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 92.
Review Date: 9/15/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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