Tuberculous adenitis

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

I Would Like to Learn About:

  • 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:

    • Fevers (rare)
    • Painless swelling of lymph nodes in the neck and other areas of the body
    • Sores (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 (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.

Related Information

  Pulmonary tubercul...    


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.


Review Date: 12/7/2014  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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