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Painful Enlarging Cervical Mass in Young Male
Jacob Lawing1, Jeremy Towns1, Matthew A Heimann1
1University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama.
Clinical Practice and Cases in Emergency Medicine
|August 19, 2024
Summary
Tuberculosis can manifest as a neck mass, known as scrofula. Early diagnosis is crucial for patients with risk factors, especially immigrants from endemic areas.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health concern.
- Scrofula, or cervical tuberculous lymphadenitis, presents as a neck mass.
- Immigrants from TB-endemic regions are at higher risk.
Purpose of the Study:
- To report a case of scrofula presenting as an enlarging neck mass.
- To highlight the importance of considering scrofula in the differential diagnosis.
- To emphasize the role of point-of-care ultrasound in diagnosis.
Main Methods:
- Case presentation of a 32-year-old male immigrant from Kenya.
- Clinical presentation: painful, enlarging right neck mass over eight weeks.
- Diagnostic tools: point-of-care ultrasound and tuberculosis blood testing.
Main Results:
- Ultrasound revealed a large cystic mass with internal septations and hypoechoic lesions.
- Tuberculosis blood test was positive.
- Cultures confirmed Mycobacterium tuberculosis growth.
Conclusions:
- Scrofula should be considered in patients with unexplained enlarging neck masses.
- Epidemiological risk factors, such as recent immigration from endemic areas, are critical.
- Prompt diagnosis and treatment are essential for managing tuberculosis of the neck.
