Scrofula: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Scrofula?
A primary care doctor usually starts the evaluation and orders tests. If tuberculosis is confirmed, an infectious disease doctor often helps guide treatment. Some patients also see an ear, nose, and throat surgeon if a procedure is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Scrofula is a name for swollen lymph nodes in the neck that are caused by tuberculosis bacteria. Lymph nodes are small bean-shaped parts of the immune system that help fight germs. In scrofula, the nodes in the neck grow large and may feel firm.
Symptoms
The main sign is one or more lumps on the side of the neck that keep getting bigger over weeks. The lumps are often not painful at first. Over time, a lump may feel rubbery or hard. Some people also have fever, night sweats, weight loss, or tiredness.
Causes and who gets it
Most cases in the United States are caused by Mycobacterium tuberculosis, the same germ that causes tuberculosis in the lungs. People at higher risk include those with weak immune systems, people who have lived where tuberculosis is common, and close contacts of someone with active tuberculosis.
How doctors diagnose it
A doctor will ask about symptoms, travel, and contact with sick people. Blood tests, a chest X-ray, and a skin or blood test for tuberculosis are often used. To confirm the cause, a doctor may remove a small piece of the lump or draw fluid with a needle for lab testing.
Treatment
Scrofula is treated with several antibiotics taken together for many months. Tuberculosis germs are slow to clear, so treatment takes a long time. Finishing the full course of medicine keeps the infection from coming back.
When to see a doctor
Anyone with a neck lump that lasts more than two or three weeks should see a doctor. Seek care sooner if the lump grows quickly, hurts a lot, drains fluid, or comes with fever, night sweats, or weight loss. Early testing can find the cause and start the right treatment.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance for visits, while a concierge doctor usually charges more and often works alongside insurance. Either kind can examine the lump, order blood tests, and start the tuberculosis testing process, referring to a specialist or surgeon when the cause is unclear or tuberculosis is confirmed.
Common questions
Is scrofula contagious?
The swollen lymph nodes themselves usually do not spread germs to others. Tuberculosis in the lungs can spread through the air. Because of this, doctors will check the lungs to see if the person is contagious. Most people with scrofula alone are not considered infectious.
Does scrofula still happen today?
Yes, but it is uncommon in the United States. It is seen more often in places where tuberculosis is common and in people with weakened immune systems.
Can the neck lump go away without treatment?
It usually does not go away on its own. It can worsen or drain without proper medicine. Treatment with several antibiotics over months is the usual approach. Results differ from person to person.
Will the lump disappear completely after treatment?
Many people see the swelling go down over months of treatment. Some are left with a small firm spot or scar. The outcome depends on how large the node was and how early treatment started.
Sources
- MedlinePlus - Lymphatic Diseases
- MedlinePlus - Tuberculosis
- Centers for Disease Control and Prevention - Tuberculosis (TB) | Tuberculosis (TB)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
