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We provide a comprehensive continuum of cancer services, including prevention, outreach, diagnostic, treatment and support services delivered by our highly skilled staff with compassion and care.
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The Center for Women & Children's Health is a hub for supporting women's and children's individual healthcare needs. The center provides support, research and unmatched patient-centered care.
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Emergency and Trauma Services is the only Level I Trauma Center in the area and serves as the tertiary referral center for medical care in East Tennessee, serving Knox County and 21 surrounding counties.
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The Heart Lung Vascular Institute brings together expertise in clinical care, teaching and research. Patients receive exceptional healthcare combined with patient-centered care.
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Scrofula
Definition
Scrofula is a tuberculous infection of the lymph nodes in the neck.
Alternative Names
Tuberculous adenitis
Causes, incidence, and risk factors
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
Signs 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
- Quantiferon gold blood test
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 bacteria (which often occurs in children), therapy usually involves antibiotics such as rifampin, ethambutol, and clarithromycin.
Surgery is sometimes used as initial treatment, depending on circumstances. It may also be used if medications are not working on the infection.
Support Groups
Expectations (prognosis)
With treatment, patients usually make a complete recovery.
Complications
- Draining sore in the neck
- Scarring
Calling your health care provider
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
Pasternack MS, Swartz MN. Lymphadenitis and lymphangitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 92.
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