Lung mass and tularaemia

Franzen, Daniel; Müller, Franco B.; Bode, P.

doi:10.1093/qjmed/hcv221

Cited by 3 publications

(2 citation statements)

References 5 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, the majority of the patients were primarily investigated for lung cancer in fast-track programs, despite all of them having symptoms consistent with infection and elevated CRP. Case reports have discussed the differential diagnostic challenge towards lung cancer [23,[32][33][34]. As these 22 patients only represented 2% of all the patients investigated in fast-track lung cancer program in the region, our findings highlight the need of detailed patient interviews in endemic regions, focusing on symptoms and risk of tularaemia.…”

Section: Radiological Findingsmentioning

confidence: 92%

“…Because of nonspecific symptoms and radiological findings, the diagnosis of pulmonary tularaemia can be challenging if not suspected at an early stage, illustrated in a case example in the supplementary material. The differential diagnostic challenge towards lung cancer may result in lengthy and comprehensive investigations [23,[32][33][34]. In our study, it took a median of 17.5 days (range 7-75 days) from referral to diagnosis in secondary care with 10 patients receiving a confirmed diagnosis after >3 weeks.…”

Section: The Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary tularaemia: a differential diagnosis to lung cancer

et al. 2020

View full text Add to dashboard Cite

BackgroundPulmonary manifestations of tularaemia are reported to be infrequent in previous publications. During 2016, we noticed an increase in the number of hospitalised patients with pulmonary tularaemia in Eastern Norway. We aimed to investigate primary pulmonary tularaemia in Eastern Norway in terms of symptoms, radiological and microbiological findings, incidence and risk exposure.MethodsA retrospective analysis of consecutive primary pulmonary tularaemia cases from 2016 until 2018 was conducted.ResultsFrom 1 September, 2016 until 31 December, 2018, 22 patients were diagnosed with primary pulmonary tularaemia at Innlandet Hospital Trust, representing 48% of all reported tularaemia cases in the region. A peak annual incidence of 3.4 in 100 000 was found in 2017.All 22 patients lived in, or had recently visited, rural areas. Eighteen patients reported risk exposure for tularaemia, such as wood chopping, outdoor activities and farming prior to symptom onset. All patients experienced fever, and 19 patients had respiratory symptoms. Ten patients were in spontaneous recovery at diagnosis.All patients had a chest computed tomography scan. Overall, 19 patients had pulmonary lesions and 18 had enlarged intrathoracic lymph nodes. The computed tomography images were described as suspicious of malignancy in 17 patients.ConclusionPulmonary manifestations in tularaemia occurred more frequently in our region than expected from previous reports. Although all patients had symptoms consistent with infection, the majority were primarily investigated considering lung cancer due to the radiology report. In endemic areas, pulmonary tularaemia may be an important differential diagnosis to lung cancer.

show abstract

Section: Radiological Findingsmentioning

confidence: 92%

Section: The Diagnosismentioning

confidence: 99%