Tularemia is becoming increasingly important as a differential diagnosis in suspicious neck masses: experience in Turkey

Atmaca, Sinan; Bayraktar, Cem; Çengel, Senem; Koyuncu, Mehmet

doi:10.1007/s00405-008-0891-6

Cited by 15 publications

(25 citation statements)

References 23 publications

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“…Based on the histopathological examinations of lymph nodes, tularemia may be confused with granulomatous infections, especially tuberculosis which is also a common disease in Turkey [18,19].…”

Section: Discussionmentioning

confidence: 99%

Tularemia: a rare cause of neck mass, evaluation of 33 patients

Çağlı

Vural

Sönmez

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of the study is to report 33 cases presenting with neck masses later diagnosed with tularemia and to raise attention to this rare zoonotic infection. A retrospective analysis of 33 patients, who were diagnosed with tularemia and treated at Erciyes University Department of Otorhinolaryngology between January 2010 and December 2010 was conducted. In conclusion, because tularemia is a rare infection, its diagnosis is frequently delayed and the symptoms of the patients may last for months without any appropriate treatment. The diagnosis of tularemia rests on clinical suspicion. For the patients, who carry risk factors for tularemia and having cervical lymphadenopathies with or without oropharyngeal symptoms and who do not response to treatment with beta-lactam antibiotics, tularemia must be kept in mind.

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Section: Discussionmentioning

confidence: 99%

Tularemia: a rare cause of neck mass, evaluation of 33 patients

Çağlı

Vural

Sönmez

et al. 2011

Eur Arch Otorhinolaryngol

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“…In the presence of a f luctuant abscess or large lymphadenopathy, surgery is needed. [8,13] Vaccination is recommended only for laboratory personnel who routinely work with this organism since it provides only incomplete protection. [10] An aberrant carotid artery is a very rare variation with an incidence of about 5% in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Fever and severe throat pain are the main symptoms of the oropharyngeal form (representing up to 12% of cases overall) that presents with pharyngitis or tonsillitis with oral ulcers and unilateral cervical, preauricular and retropharyngeal lymphadenopathy. [11][12][13][14] This form can be acquired by exposure to contaminated water or consumption of poorly cooked meat. [15] Glandular tularemia involves lymphadenopathy, generally cervical in the deep jugular chain without an identifiable skin lesion and 42% of cases feature high fever associated with bradycardia (pulse-temperature dissociation).…”

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confidence: 99%

A retropharyngeal abscess caused by Francisella tularensis with an aberrant internal carotid artery on the same side

Kılıç¹

2017

KBB Uygulamaları

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ABSTR ACTTularemia is a rare zoonotic disease caused by Francisella tularensis, which is a pathogenic spp. of Gram-negative, noncapsular, aerobic coccobacillus. Insect or rodent bite, contact with animals, consuming contaminated animal products, and water may be the routes of transmission. This bacterial infection has a significant place in the otolaryngology practice, as some patients with tularemia have signs and symptoms localized in the head and neck. In this article, we report a 60-year-old female patient with a four-month history of sore throat, dysphagia, right-sided neck mass, and fever. Radiological studies revealed a retropharyngeal abscess with a right-sided aberrant internal carotid artery. To the best of our knowledge, this is the first case of a retropharyngeal abscess caused by Francisella tularensis with an aberrant internal carotid artery on the same side.

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“…Ülkemiz s verilerini dikkate aldığımızda, geçmiş yıllara göre kıyaslandığında günümüzde pulmoner tüberküloza (TB) yakalanan bireylerin sayısının gittikçe azaldığını, diğer taraftan akciğer dışı TB (özellikle de servikal TB lenfadeniti) olgularının sıklığının arttığını gözlemlemekteyiz 2 . Bununla birlikte servikal lenfadenit olgularının en sık karşılaşılan granülomatöz enfeksiyöz etkenlerinden biri olarak değerlendirilen orofarengeal tularemi bildirimlerinin de ülkemizde son yıllarda belirgin olarak artmaya başladığını müşahade etmekteyiz 3 . Her iki lenfadenit etkeni de klinik ve histopatolojik olarak birbirleriyle karışabilmektedir.…”

Section: Tarafından Bildirilen "Tularemi Lenfadeniti şüPhesi Ile Alınunclassified

Tuberculosis and Tularemia as Part of the Differential Diagnosis in Cervical Lymphadenitis

Karagöz¹,

Ülçay²,

Hatipoğlu

et al. 2014

Mikrobiyol Bul

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We have read with interest the recently published article entitled "Investigation of the presence of Mycobacterium tuberculosis in the lymph node aspirates of the suspected tularemia lymphadenitis cases" by Albayrak et al. published in s Mikrobiyol Bul 2014; 48(1): 129-34. They concluded that tuberculous lymphadenitis (TCL) should be kept in mind in suspected tularemia cases and those patients should also be investigated simultaneously for the presence of TCL. With reference to data provided by the Ministry of Health in Turkey, the number of reported cases of pulmonary tuberculosis in comparison to previous years is currently on decline whereas a gradual increase in extra-pulmonary (specifi cally cervical TCL) cases has been observed. Besides, as one of the most common causes of cervical lymphadenitis, we are witnessing a marked increase in granulomatous infections which have been part of the evaluated cases of oropharyngeal tularemia in Turkey. In fact, differentiation of the two types of lymphadenitis can be confusing on the basis of clinical and histopathological fi ndings. Thus, investigating the presence of M.tuberculosis in cervical lymph node aspirates of tularemia suspected cases is a vital contribus tion, specifi cally in a geographical region that is considered endemic for both diseases. We would therefore like to note the importance of this study and thank the authors for their comprehensive contribution. Contrary to what is noted in the study, cervical lymphadenitis due to acute tonsillopharyngitis unresponsive to penicillin and its derivatives, has been regarded as cervical TCL due to their histopathological appearance and have been treated unnecessarily with long-term antituberculous drugs. There are some publications from Turkey indicating the detection of Francisella tularensis antibodies and nucleic acids s in the patients who were histologically diagnosed as TCL. In situations where the exact etiology of cervical lymphadenitis is not determined, treatment is delayed, disease duration is prolonged and patients are forced into visiting multiple physicians and hospitals. In this case uneccessary protocols such as lymph node excision and various surgical procedures are performed to rule out the presence of commonly encountered malignancies like lymphoma. On the other hand, lymph node suppuration is more commonly seen among these group of patients. As a conclusion, tularemia and TCL should be kept in mind as different endemic entities in widespread geographical regions such as Turkey. In particular, early serological and microbiological investigations should be performed for early diagnosis and appropriate treatment in such patients.

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Tularemia is becoming increasingly important as a differential diagnosis in suspicious neck masses: experience in Turkey

Cited by 15 publications

References 23 publications

Tularemia: a rare cause of neck mass, evaluation of 33 patients

Tularemia: a rare cause of neck mass, evaluation of 33 patients

A retropharyngeal abscess caused by Francisella tularensis with an aberrant internal carotid artery on the same side

Tuberculosis and Tularemia as Part of the Differential Diagnosis in Cervical Lymphadenitis

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