Tuberculous lymphadenitis is among the most frequent presentations of extrapulmonary tuberculosis (TB). Tuberculous lymphadenitis in the cervical region is known as scrofula . This syndrome can also be caused by nontuberculous mycobacteria.
TB is responsible for up to 43 percent of peripheral lymphadenopathy in the developing world . In rural India, the prevalence of tuberculous lymphadenitis in children up to 14 years of age is approximately 4.4 cases per 1000 . In the United States, about 20 percent of patients with TB have extrapulmonary disease, and lymphadenitis is a presenting symptom in about 30 to 40 percent of cases [4-6]. (See "Evaluation of peripheral lymphadenopathy in adults".)
The human immunodeficiency virus (HIV) epidemic has been associated with an increase in the total incidence of TB and an increased proportion of miliary, disseminated, and extrapulmonary TB cases including lymphadenitis . (See "Epidemiology of tuberculosis" and "Epidemiology and pathology of extrapulmonary and miliary tuberculosis".)
Issues related to tuberculous lymphadenitis will be reviewed here. Other issues related to tuberculosis are discussed separately. (See related topics.)
Isolated peripheral tuberculous lymphadenopathy is usually due to reactivation of disease at a site seeded hematogenously during primary tuberculosis (TB) infection, perhaps years earlier .