An old cause of cervical lymphadenopathy

Jason S Biswas; Muhammed U Ebrahimsa; William Newsholme

doi:10.7861/clinmedicine.15-1-104

A 77-year-old Caucasian male presented with productive cough for two days. He had lived in the UK all his life. He had multiple small nodules throughout his neck consistent with lymphadenopathy, with a large scar on the right side (Fig 1).

Fig 1.

Scar on right side of neck.

Chest radiography showed multiple calcified lymph nodes in the neck and left axilla (Fig 2). He revealed he had had scrofula in 1957, treated with streptomycin and debulking surgery to the right side of the neck. He was discharged well with antibiotics.

Fig 2.

PA chest radiograph showing multiple calcified lymph nodes.

Scrofula is most commonly caused by Mycobacterium tuberculosis in adults. Now uncommon in the Western world, practitioners may see this radiographic appearance amongst their older population who contracted this when tuberculosis was endemic and surgery a mainstay of treatment.