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To the Editor:—
In The Journal (199:681, 1967) Dr. V. A. Plessinger answers a query on tuberculous cervical lymphadenitis. I would like to take exception to two of his statements which appear to be highly controversial. In the first statement Dr. Plessinger says, "Tuberculous cervical lymphadenitis most commonly is secondary to tuberculosis of the tonsils or the mouth." While tuberculosis of the mouth and/or tonsils is an exceedingly rare condition, it usually (but not always) is associated with faradvanced pulmonary tuberculosis in debilitated patients. Tuberculous cervical lymphadenitis ("scrofula" of the old days), is a much more frequently encountered entity. As a rule it is not associated with any lesions of the mouth, tonsils, etc. It is frequently a manifestation of primary tuberculous infection and is often found simultaneously with tracheobronchial lymphadenopathy and with supraclavicular glands involvement and retrograde extension to the cervical glands. Every physician who reads chest x-ray
Vishnevsky C. Tuberculous Cervical Lymphadenitis. JAMA. 1967;200(4):350. doi:10.1001/jama.1967.03120170122042