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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.