title: Recurrent neck abscesses due to cervical tuberculous lymphadenopathy in an elderly woman post-splenectomy: a case report.
abstract: BACKGROUND
  There are approximately 7000 new cases of tuberculosis every year in the UK, the majority of which are pulmonary. Approximately 5% affect the lymph nodes in immunocompetent patients. Scrofula is an old term used to describe lymph nodes of the neck infected with tuberculosis
  
  
  METHODS
  In the elderly population, growing neck lumps are always treated as red flags until a diagnosis is confirmed. Here, the case of an 89-year-old Caucasian woman is presented. She was reluctant to seek medical help as she feared the cause was sinister and did not want surgical intervention.
  
  
  CONCLUSIONS
  It is difficult to culture tuberculosis from superficial swabs, resulting in a high proportion of false negative results. Where there is a high degree of clinical suspicion for tuberculosis, it is important to consider a biopsy with culture. Patients over the age of 65 have waning immunity and are therefore a vulnerable group for acute infections as well as the re-activation of indolent organisms. Post-splenectomy patients are at a major disadvantage during sepsis and when a cellular immune response is required, such as when faced with a Mycobacterium tuberculosis infection. Scrofula is treated with a similar regime as pulmonary tuberculosis and has a near 100% success rate.
authors.affiliation: Royal Victoria Hospital, Medical Department, 274 Grosvenor Road, Belfast BT12 6BA. aaronniblock@doctors.net.uk.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Niblock