Oculoglandular Tularemia From Crushing an Engorged Tick

Abstract

We report on an unusual case of oculoglandular tularemia acquired after crushing a tick removed from a dog. As a droplet sprayed into the patient’s eye the eyelids became inflamed, and on the fourth day, a high fever started. The prompt antibiotic treatment prevented serious complication.

Francisella tularensis Infection Causing Parinaud Oculoglandular Syndrome

“…In the oculoglandular form, the route of transmission is highly variable (eg, directly by hands contaminated at flaying of infected animals, indirectly by periocular arthropod bites, or swimming or bath in contaminated water) [12][13][14]. Lakos et al report an OGT acquired after crushing a tick removed from a dog [15]. In our case the twig scratching the patient's right eye could have contributed to inoculation of the infective agent.…”

“…The duration of ciprofloxacin therapy depends on symptoms, but a minimum of 10-14 days is suggested [8]. To prevent possible complications, adequate antibiotic therapy should be started immediately at the slightest suspicion of tularemia [15]. Beta-lactams are not indicated, although several authors mention their empiric administration between the onset of the disease and the suspicion of tularemia [8,[12][13][14][15]25].…”