Cases from the aerospace medicine residents' teaching file. Case #58. Scrofula

A patient presenting with dysphagia was treated for bacterial lymphadenitis with broad spectrum antibiotics by an internist and an otolaryngologist. The clinical picture, histopathology, diagnosis, aeromedical disposition, and a brief, but pertinent historical background are described. The case was unique in that the diagnosis would have been missed had it not ultimately been for the timely intervention and advice of a senior preventive medicine physician. The physician recognized the high probability of extrapulmonary tuberculosis manifesting itself as scrofula. Tuberculosis cases in the United States have begun to climb in number and alertness to this infection is warranted.