scrofula

Chronic tuberculous lymphadenitis of the cervical lymph nodes. Etiology: 1) Mycobacterium scrofulaceum 2) other Mycobacteria? Clinical manifestations: 1) any cervical nodes may be involved 2) anterior triangle just below neck is most frequent site of disease 3) tuberculous nodes are generally rubbery & not tender 4) nodes become harder & matted with time 5) chronic draining fistulas may occur, but are rare 6) disease course is generally indolent Laboratory: 1) diagnosis is established by surgical biopsy a) culture is essential b) histologic examination with acid fast stain 2) tuberculin skin testing Management: 1) treat same as pulmonary TB for 6-9 months 2) culture prior to initiation of antibiotic therapy 3) patients are NOT a public health hazard

References

Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 324, 712