Incidence of Scrofula in Enlarged Neck Nodes

Abstract

To determine the incidence of scrofula (tubercular lymphadenitis) in enlarged neck nodes, prospective study is carried out in the Department of General Surgery, NIMS Medical College, Jaipur for three years from June 2011 to May 2014. The study included a group of 130 patients with cervical lymphadenopathy. All patients were clinically examined and investigated thoroughly. CBC, ESR, X-ray chest and Montoux’s test were performed. Fine Needle Aspiration Cytology (FNAC) and AFB staining of enlarged lymph node was done. In patients whose diagnosis was doubtful, excisional biopsy was done. Patients with tuberculosis were treated with anti-tubercular therapy Category 1. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Of the 130 cases with enlarged neck nodes, 94 (72.3%) had tubercular lymphadenitis, 26 (20%) cases had reactive lymphadenitis, and 6 (4%) cases were diagnosed with metastatic neck nodes. Majority of the patients were in the age group between 10–20 years. No difference was observed between male and female in this study. Anterior cervical group of lymph nodes, both superficial and deep, were most commonly affected group of nodes accounting for 57 (43.84%) cases and preauricular region 2 (1.53%) case being the least commonly affected site. FNAC was investigation of choice though excision biopsy of lymph nodes was required occasionally. There is high incidence of scrofula in patients with enlarged neck nodes.

Keywords: scrofula, fine needle aspiration cytology, tubercular lymphadenitis, tuberculosis.