Tularemia: A Rare Cause of Neck Mass

Karlıdağ, Turgut; Keleş, Erol; Kaygusuz, İrfan; Yüksel, Koray; Yalçin, Süleyman

doi:10.5152/tao.2015.985

Cited by 2 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fourth, blood inflammatory markers, in particular C-reactive protein (CRP), were mostly low ( Supplementary Figure 4D ). This finding differs from what has been reported in adult patients with oropharyngeal disease [ 56 ]. Other investigators found that CRP values in pulmonary disease were higher than in ulceroglandular disease in adults and peaked in the first week of illness [ 57 ].…”

Section: Discussioncontrasting

confidence: 99%

Pediatric Tularemia—A Case Series From a Single Center in Switzerland

Schöbi

Agyeman

Duppenthaler

et al. 2022

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background The incidence of tularemia has recently increased throughout Europe. Pediatric tularemia typically presents with ulceroglandular or glandular disease and requires antimicrobial therapy not used in the empirical management of childhood acute lymphadenitis. We describe the clinical presentation and course in a case series comprising 20 patients. Methods Retrospective analysis of a single-center case series of microbiologically confirmed tularemia in patients below 16 years of age diagnosed between 2010 and 2021. Results Nineteen patients (95%) presented with ulceroglandular (n = 14) or glandular disease (n = 5), respectively. A characteristic entry site lesion (eschar) was present in 14 (74%). Fever was present at illness onset in 15 patients (75%) and disappeared in all patients before targeted therapy was initiated. The diagnosis was confirmed by serology in 18 patients (90%). While immunochromatography (ICT) was positive as early as on day 7, a microagglutination test (MAT) titer 1:≥160 was found no earlier than on day 13. Sixteen patients (80%) were initially treated with an antimicrobial agent ineffective against F. tularensis. The median delay (range) from illness onset to initiation of targeted therapy was 12 days (range, 6-40). Surgical incision and drainage was ultimately performed in 12 patients (60%). Conclusion Pediatric tularemia in Switzerland usually presents with early, self-limiting fever, and a characteristic entry site lesion with regional lymphadenopathy draining the scalp or legs. Particularly in association with a tick exposure history, this presentation may allow early first-line therapy with an agent specifically targeting F. tularensis, potentially obviating the need for surgical therapy.

show abstract

Section: Discussioncontrasting

confidence: 99%

Pediatric Tularemia—A Case Series From a Single Center in Switzerland

Schöbi

Agyeman

Duppenthaler

et al. 2022

Open Forum Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Tularemia has generally assumed greater importance in Turkey in recent years because of outbreaks deriving from water sources [20,21]. Aktas et al reported an outbreak of 55 cases of oropharyngeal tularemia detected in 2013 and derived from drinking water [13].…”

Section: Discussionmentioning

confidence: 99%

“…It is also effective in children at 15 mg/kg/day over the same period. The therapeutic period may sometimes exceed two weeks in patients with slow clinical improvement [21,38].…”

Section: Discussionmentioning

confidence: 99%

A rare cause requiring consideration in the differential diagnosis of neck masses: tularemia

Şahin

Kılıç

Sakat

et al. 2023

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Tularemia is a zoonotic disease caused by the Gram-negative coccobacillus Francisella tularensis. It is frequently overlooked in the differential diagnosis of neck masses because of its rarity. The purpose of this study is to report cases diagnosed with tularemia among patients presenting to our clinic with neck masses and to share our experience. Methodology: Patients presented to our hospital with cervical masses and diagnosed with tularemia were included in this retrospective study. Medical files of all patients were evaluated, and physical examination findings, titration values, date of diagnosis, location of the abscess or mass, place of residence, occupation, drinking water sources, sedimentation (SED), C-reactive protein (CRP), and white blood cell (WBC) values were recorded. Results: Seventy-six patients were included in the study. Forty patients (52.6%) were living in rural villages and 36 (47.4%) in urban areas. Thirty-one (40.8%) were engaged in animal husbandry and 29 (38.2%) in agriculture. In terms of drinking water sources, 59 patients (73.6%) obtained water from the mains, while 10 (13.32%) used well water. The most frequently observed clinical findings were swelling in the neck, sore throat, lethargy, and fever. Neck swelling frequently occurred in levels II and III. Conclusions: Since tularemia is rare and there are no specific clinical findings, diagnosis may be problematic. Ear, nose and throat (ENT) specialists should be familiar with the clinical symptoms of tularemia in the head and neck region and should consider a preliminary diagnosis of tularemia in the differential diagnosis of persistent neck masses.

show abstract

Tularemia: A Rare Cause of Neck Mass

Cited by 2 publications

References 9 publications

Pediatric Tularemia—A Case Series From a Single Center in Switzerland

Pediatric Tularemia—A Case Series From a Single Center in Switzerland

A rare cause requiring consideration in the differential diagnosis of neck masses: tularemia

Contact Info

Product

Resources

About