Scrofula: Symptoms, Causes, Treatment

What are the symptoms of scrofula?

Scrofula, also known as tuberculous lymphadenitis, primarily affects the lymph nodes and is a form of extrapulmonary tuberculosis. The symptoms include:

• Swollen Lymph Nodes: Enlarged lymph nodes, typically in the neck, are the most common symptom. These nodes may be tender or painless and can form abscesses.
• Fever: Persistent, low-grade fever is common.
• Night Sweats: Excessive sweating at night can occur.
• Weight Loss: Unexplained weight loss may be observed.
• Fatigue: General feeling of weakness or fatigue is common.
• Skin Changes: In advanced cases, the skin over the lymph nodes can become ulcerated or form a “cold abscess.”

In some cases, scrofula may be associated with other symptoms of tuberculosis if the infection has spread beyond the lymph nodes.

What are the causes of scrofula?

Scrofula, also known as tuberculous lymphadenitis, is a form of tuberculosis that primarily affects the lymph nodes, particularly in the neck. The causes of scrofula are linked to infection with Mycobacterium tuberculosis, the same bacterium responsible for pulmonary tuberculosis. Here are the primary causes:

• Mycobacterium tuberculosis Infection: Scrofula is caused by infection with the tuberculosis bacteria. It occurs when the bacteria spread from a primary site of infection (often the lungs) to the lymph nodes, particularly in the neck area.
• Transmission: The infection typically occurs through inhalation of airborne droplets from a person with active pulmonary tuberculosis. Once inhaled, the bacteria can spread to other parts of the body, including the lymph nodes.
• Immune System Factors: People with weakened immune systems, such as those with HIV/AIDS or other immunocompromising conditions, are at a higher risk of developing scrofula. Additionally, malnutrition can also increase susceptibility.
• Chronic Exposure: Long-term exposure to someone with active tuberculosis can increase the risk of developing scrofula.
• Pediatric Cases: In children, scrofula is often a result of primary tuberculosis, where the initial infection can lead to lymphatic involvement without significant pulmonary symptoms.

Treatment for scrofula typically involves a regimen of antibiotics used to treat tuberculosis, such as isoniazid, rifampin, ethambutol, and pyrazinamide, for an extended period. Early diagnosis and appropriate treatment are crucial to managing the condition effectively and preventing complications.

What is the treatment for scrofula?

The treatment for scrofula, or tuberculous lymphadenitis, involves a combination of antibiotics and, in some cases, surgical intervention. Here’s an overview of the treatment approach:

• Antibiotic Therapy: The primary treatment for scrofula is a course of antibiotics specifically targeted at Mycobacterium tuberculosis. The standard regimen typically includes:
• Isoniazid (INH)
• Rifampin (RIF)
• Ethambutol (EMB)
• Pyrazinamide (PZA) This combination of drugs is usually administered for a minimum of 6 to 12 months to effectively eradicate the infection and prevent recurrence.
• Directly Observed Therapy (DOT): In some cases, to ensure adherence to the lengthy treatment regimen, health care providers may use Directly Observed Therapy (DOT), where a healthcare worker observes the patient taking their medication.
• Surgical Intervention: If the lymph nodes are significantly swollen, causing discomfort or complications, or if there is the formation of abscesses, surgical intervention may be necessary. This can involve draining the abscess or removing affected lymph nodes.
• Supportive Care: Supportive treatments may include pain management, good nutrition, and addressing any complications that arise from the disease or its treatment.
• Management of Side Effects: Monitoring and managing potential side effects of the tuberculosis medications is essential to ensure compliance with the treatment regimen.
• Follow-Up: Regular follow-up with a healthcare provider is important to monitor the response to treatment, check for potential side effects, and ensure that the infection is being effectively controlled.

Timely diagnosis and consistent treatment are crucial in managing scrofula and preventing serious complications.