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    Scrofula

    Tuberculous adenitis

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

    Causes

    Scrofula 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.

    Symptoms

    • Fevers (rare)
    • Painless swelling of lymph nodes in the neck and elsewhere in body
    • Sores (ulceration -- rare)
    • 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
    • Other tests for TB

    Treatment

    When 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 mycobacteria (which often occurs in children), treatment usually involves antibiotics such as rifampin, ethambutol, and clarithromycin.

    Surgery is sometimes used first. It may also be used if medications are not working.

    Outlook (Prognosis)

    With treatment, patients usually make a complete recovery.

    Possible Complications

    • Draining sore in the neck
    • Scarring

    When to Contact a Medical Professional

    Call 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.

    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. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 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. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 250.

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          Review Date: 10/6/2012

          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. Health Solutions, Ebix, Inc.

          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. 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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          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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