History:

This on-year-old child presented with a sinus over the left axilla. The lesion started as nodule around 4 months ago. There was history of recurrent breaking down of the nodule with discharge of sero-purulent material, and healing/sealing with sinus formation.

A diagnosis of scrofuloderma was made clinically and the child id being investigated.

Such cases occur in infants rarely. One has to look for bacteriological, immunological, and radiological evidence too. A PCR for M. tuberculosis will be very useful in clinching the diagnosis.

Treatment will have to be custom made for the child with Rifampicin, isoniazid, ethambutol, and pyrazinamide depending on the child's body weight.