Hostname: page-component-54dcc4c588-2bdfx Total loading time: 0 Render date: 2025-10-09T13:34:29.630Z Has data issue: false hasContentIssue false
  • English
  • Français

Scrofula as a presentation of tuberculosis and HIV

Published online by Cambridge University Press:  21 May 2015

Katrina Barnett  and
Ron Medzon
Katrina Barnett*
Affiliation:
Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Mass.
Ron Medzon
Affiliation:
Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Mass.
*
Dowling 1 South, 1 Boston Medical Center Place, Boston MA 02118; katrina.barnett@gmail.com

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Scrofula, or tuberculous cervical lymphadenitis, though now rare, is more commonly seen in minorities, women and immunosuppressed patients, especially those with HIV. We discuss a patient who presented to the emergency department with an anterior neck abscess and was diagnosed with both advanced HIV and disseminated tuberculosis. A high level of suspicion is necessary to make this diagnosis, but given an increasing degree of global mobility, such patients may present anywhere. Medical management is effective, though difficult. Early diagnosis improves the patient's individual prognosis and may prevent further exposure and transmission to the population.

Information

Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 3 , May 2007 , pp. 176 - 179
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1.Geldmacher, H, Taube, C, Kroeger, C, et al. Assessment of lymph node tuberculosis in northern Germany: a clinical review. Chest 2002;121:1177–82.Google Scholar
2.Mandell, GL, Dolin, R, eds. Douglas, and Bennett’s principles and practice of infectious diseases. 6th ed. Philadelphia (PA): Elsevier; 2005.Google Scholar
3.Barnes, PF, Lakey, DL, Burman, WJ. Tuberculosis in patients with HIV infection. Infect Dis Clin North Am 2002;16:107–26.CrossRefGoogle ScholarPubMed
4.Corbett, EL, Watt, CJ, Walker, N, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003;163:1009–21.CrossRefGoogle ScholarPubMed
5.Frieden, TR, Sterling, TR, Munsiff, SS, et al. Tuberculosis. Lancet 2003;362:887–99.CrossRefGoogle ScholarPubMed
6.Shriner, KA, Mathisen, GE, Goetz, MB. Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. Clin Infect Dis 1992;15:601–5.CrossRefGoogle ScholarPubMed
7.Lee, MP, Chan, JW, Ng, KK, et al. Clinical manifestations of tuberculosis in HIV-infected patients. Respirology 2000;5:423–6.CrossRefGoogle ScholarPubMed
8.Jones, BEYoung, SM, Antoniskis, D, et al. Relationship of the manifestations of tuberculosis to CD4 cell counts in patients with human immunodeficiency virus infection. Am Rev Respir Dis 1993;148:1292–7.CrossRefGoogle ScholarPubMed
9.King, AD, Ahuja, AT, Metreweli, C. MRI of tuberculous cervical lymphadenopathy. J Comput Assist Tomogr 1999;23:244–7.Google Scholar
10.Drake, WM, Elkin, SL, al-Kutoubi, A, et al. Pulmonary artery occlusion by tuberculous mediastinal lymphadenopathy. Thorax 1997;52:301–2.CrossRefGoogle ScholarPubMed
11.Barnes, PF, Yang, Z, Pogoda, JM, et al. Foci of tuberculosis transmission in central Los Angeles. Am J Respir Crit Care Med 1999;159:1081–6.CrossRefGoogle ScholarPubMed
12.Huebner, RE, Schein, MF, Hall, CA, et al. Delayed-type hyper-sensitivity anergy in human immunodeficiency virus-infected persons screened for infection with mycobacterium tuberculosis. Clin Infect Dis 1994;19:26–32.CrossRefGoogle Scholar
13.de Jong, BC, Israelski, DM, Corbett, EL, et al. Clinical management of tuberculosis in the context of HIV infection. Annu Rev Med 2004;55:283–301.Google Scholar
14.van Loenhout-Rooyackers, JH, Laherj, RJ, Richter, C, et al. Shortening the duration of treatment for cervical tuberculous lymphadenitis. Eur Respir J 2000;15:192–5.CrossRefGoogle ScholarPubMed
15.Weis, SE, Burgess, G. Tuberculosis control in a border state. Treatment of the foreign-born. Infect Dis Clin North Am 2002;16:59–71.Google Scholar