Bilateral Posterior Neck Masses in an 8-Year-Old Boy: A Case of Pediatric Tularemia of the Head and Neck

Kumar, Ayan; Kolb, Caroline M.; Briddell, Jenna W.; Aaronson, Nicole Leigh

doi:10.1177/0145561320923830

Cited by 1 publication

(2 citation statements)

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“…These outbreaks led to a greater awareness for tularemia when diagnosing masses. Comparative case series were reported by ENT physicians, albeit few in number [14,16,[22][23][24]. In the present study, 22.3% (17 patients) did not use water from the mains, relying instead on spring or well water.…”

Section: Discussioncontrasting

confidence: 46%

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

Şahin

Kılıç

Sakat

et al. 2023

J Infect Dev Ctries

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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.

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Section: Discussioncontrasting

confidence: 46%

“…In North America and European countries, ulceroglandular tularemia represents 80% of all tularemia cases. While in Turkey, Bulgaria, and Kosovo, oropharyngeal tularemia, which is generally transmitted through contaminated water and foods, is the most frequent form [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%