A case of cervical radiculopathy due to tuberculosis cervical lymphadenitis

Cervical tuberculosis lymphadenitis (CTL), classically known as scrofula, presents as a progressive unilateral neck swelling over weeks to months. In the United States, extrapulmonary tuberculosis (EPTB), principally lymphadenitis, comprises approximately 10% of tuberculosis cases, and unlike pulmonary tuberculosis, has not been declining in prevalence.1 It is most prevalent among foreign-born individuals from Southeast Asia and India, and occurs most frequently in the cervical region.2 Despite the close proximity of cervical lymph nodes to exiting nerve roots, clinical radiculopathies are rare. This is particularly interesting considering the infection causes mass effect in the posterior cervical triangle, crowding an area traversed by many nerves arising from the cervical region.3 It is possible that subtle radicular symptoms are more common but unrecognized, and that our case represents a more dramatic example along a spectrum of disease.