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Bohl I, Stimmer H, Lee M, Wollenberg B, Hofauer B, Stenzl A. [Treatment-refractory lymphadenopathy after consumption of dairy products]. HNO 2023; 71:186-188. [PMID: 36400850 DOI: 10.1007/s00106-022-01246-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Isabell Bohl
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Herbert Stimmer
- Institut für Diagnostische und Interventionelle Radiologie, Klinikum rechts der Isar der Technische Universität München, München, Deutschland
| | - Marcel Lee
- II. Medizinische Klinik, Klinikum rechts der Isar der Technische Universität München, München, Deutschland
| | - Barbara Wollenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Benedikt Hofauer
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Anna Stenzl
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
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Troha K, Božanić Urbančič N, Korva M, Avšič-Županc T, Battelino S, Vozel D. Vector-Borne Tularemia: A Re-Emerging Cause of Cervical Lymphadenopathy. Trop Med Infect Dis 2022; 7:tropicalmed7080189. [PMID: 36006281 PMCID: PMC9412492 DOI: 10.3390/tropicalmed7080189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 12/16/2022] Open
Abstract
Tularemia is a zoonosis caused by the highly invasive bacterium Francisella tularensis. It is transmitted to humans by direct contact with infected animals or by vectors, such as ticks, mosquitos, and flies. Even though it is well-known as a tick-borne disease, it is usually not immediately recognised after a tick bite. In Slovenia, tularemia is rare, with 1–3 cases reported annually; however, the incidence seems to be increasing. Ulceroglandular tularemia is one of its most common forms, with cervical colliquative lymphadenopathy as a frequent manifestation. The diagnosis of tularemia largely relies on epidemiological information, clinical examination, imaging, and molecular studies. Physicians should consider this disease a differential diagnosis for a neck mass, especially after a tick bite, as its management significantly differs from that of other causes. Tularemia-associated lymphadenitis is treated with antibiotics and surgical drainage of the colliquated lymph nodes. Additionally, tularemia should be noted for its potential use in bioterrorism on behalf of the causative agents’ low infectious dose, possible aerosol formation, no effective vaccine at disposal, and the ability to produce severe disease. This article reviews the recent literature on tularemia and presents a case of an adult male with tick-borne cervical ulceroglandular tularemia.
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Affiliation(s)
- Kaja Troha
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Nina Božanić Urbančič
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Saba Battelino
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Domen Vozel
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
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Prah M, Kenk A, Rejc Marko J. Skin involvement in Francisella tularensis infection: a case report of two clinical cases. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2022. [DOI: 10.15570/actaapa.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kukla R, Kračmarová R, Ryšková L, Bavlovič J, Pellantová V, Bolehovská R, Fajfr M, Pavlík I, Boštík P. Francisella tularensis caused cervical lymphadenopathy in little children after a tick bite: Two case reports and a short literature review. Ticks Tick Borne Dis 2021; 13:101893. [PMID: 34990926 DOI: 10.1016/j.ttbdis.2021.101893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
Although Francisella (F.) tularensis is a well-described and understood zoonotic pathogen, its importance in Central Europe is relatively minor and, as such, tularaemia may be missed in the differential diagnosis. The annual incidence of tularaemia in the Czech Republic is relatively stable with up to 100 reported cases per year, except in the epidemic years 1998 and 1999 with 225 and 222 reported cases, respectively. It is, however, higher in comparison with the neighbouring countries. The common route of transmission in Central Europe is handling infected animals. Tularaemia is not commonly recognized as a tick-borne disease. Here we report two rare cases of a tick bite-associated ulceroglandular form of tularaemia in 2.5-year-old and 6.5-year-old children presenting with cervical lymphadenopathy. The unusual and interesting features of those cases are the young age and relatively uncommon route of transmission suggesting possible changes in the epidemiology of tularaemia in the Czech Republic. Therefore, the infection with F. tularensis should be considered in the differential diagnosis after a tick bite even in infants.
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Affiliation(s)
- Rudolf Kukla
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Renata Kračmarová
- Clinic of Infectious Diseases, University Hospital, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Lenka Ryšková
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Jan Bavlovič
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic; Department of Molecular Pathology and Biology, Faculty of Military Health Sciences, University of Defence, Trebešská 1575, 50001 Hradec Králové, Czech Republic
| | - Věra Pellantová
- Clinic of Infectious Diseases, University Hospital, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Radka Bolehovská
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Miroslav Fajfr
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - Ivo Pavlík
- Faculty of Regional Development and International Studies, Mendel University in Brno, tr. Generála Píky 7, 61300, Brno, Czech Republic
| | - Pavel Boštík
- Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic.
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