Scrofula
Key points
- Scrofula is a tuberculous infection of the skin of the neck, most often caused by mycobacteria (including Mycobacteriumtuberculosis), in adults.
- Infection with mycobacteria is usually caused by inhaling air contaminated by these organisms.
- When infection is caused by Mycobacteriumtuberculosis, treatment is usually with 9 to 12 months of antibiotics.
- Calling your health care provider Call your provider if your child has a swelling or group of swellings in the neck.
Alternative names
Tuberculous adenitis
Definition
Scrofula is a tuberculous infection of the skin of the neck, most often caused by mycobacteria (including Mycobacteriumtuberculosis), in adults. In children, it is usually caused by Mycobacterium scrofulaceum or Mycobacterium avium.
Causes, incidence, and risk factors
Infection with mycobacteria is usually caused by inhaling air contaminated by these organisms. The bacteria spread throughout the body, and may cause rubbery enlargement of the Lymph nodes in the neck (cervical Lymph nodes) as well as elsewhere. If these are not treated, the Lymph nodes may become ulcerated, producing draining sores.
Symptoms
- painless swelling of cervical (neck) Lymph nodes
- ulceration is rare today
- Lymph nodes may be enlarged elsewhere
- fevers, chills, sweats, and Weight Loss can occur in 20% of individuals
Signs and tests
- histology (examination under a microscope) shows granulomas
- special stains (such as AFB of the material) may be positive
- Mycobacteriumtuberculosis and other mycobacteria can be cultured from lymph node specimens
- TB tine or PPD tests are usually positive
- chest x-rays can be abnormal due to old Tuberculosis infection or simultaneous pulmonary tuberculosis
Treatment
When infection is caused by Mycobacteriumtuberculosis, treatment is usually with 9 to 12 months of antibiotics. Several antibiotics need to be used at once, to avoid the bacterium becoming antibiotic-resistant. Common antibiotics for scrofula include:
- INH
- rifampin
- pyrazinamide
- ethambutol
When infection is caused by mycobacteria other than Mycobacterium tuberculosis, as is often seen in children, therapy usually involves antibiotics, such as rifampin, ethambutol, and clarithromycin.
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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