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Scrofula

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

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.

Alternative Names

Tuberculous adenitis

References

Ellner JJ. Tuberculosis. In: Goldman L, Schafer AI, eds.Goldman's Cecil Medicine

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, eds.Principles and Practice of Infectious Diseases

Update Date 12/7/2014

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