A case of tularemia presenting as a dental abscess: case report.
ABSTRACT OBJECTIVE: The purpose of this report is to present a tularemia case accompanied by a neck mass that easily may be confounded with dental abscess. SUMMARY: Francisella tularensis is a potential agent of biologic terrorism. Thirty percent of the symptoms seen in tularemia localize in the head and neck region and are sometimes mistaken for complications of a dental abscess. To our knowledge, reports of the differential diagnostic characteristics of tularemia are lacking in the dental literature and, to date, no dental journal articles have focused on the disease. In this present case, a 51-year-old woman arrived at the public health department with high fever and facial swelling. The findings suggested a dental origin and the patient was directed to dentistry. Radiology and a detailed intraoral and extraoral examination failed to reveal a dental problem. Fortunately, the patient was known to come from a tularemia region; with the suspicion of tularemia the patient was referred to the faculty of medicine. Serologic tests showed that the patient had a Francisella tularensis infection.
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ABSTRACT: Tularemia is a zoonotic disease caused by Francisella tularensis. The microorganism is transmitted to humans by contact with, or ingestion of, infected animal tissues, by insect bites, consumption of contaminated food or water, or from inhalation of aerolized bacteria. In this report we describe a case of tularemia presenting with multiple cervical lymphadenitis in Asturias (Spain). Final diagnosis was established based on a serological test. The patient was successfully managed with surgery and streptomycin for 2 weeks. The ulceroglandular form of tularemia should be considered in the differential diagnosis of cervical lymphadenitis, particularly in those not responding to penicillin treatment. To our knowledge, this is the first case described in Asturias, a north coast county of Spain.Medicina oral, patologia oral y cirugia bucal 05/2009; 14(4):E180-2. · 1.02 Impact Factor
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ABSTRACT: Neck mass can be an initial finding of many diseases at any age. The differential diagnosis is broad and includes inflammatory, congenital and neoplastic lesions. We retrospectively analyzed charts of the 145 patients with neck mass and without known primary malignancy whose diagnoses were confirmed with histopathologic and serologic examination between July 2003 and July 2008. Twenty-six patients (17.9%) were diagnosed with tularemia. Before 2004, serologic testing for tularemia was not a part of our workup for patients with an inflammatory neck mass. Otolaryngologists should be familiar with head and neck manifestations of tularemia and consider the disease in the differential diagnosis of neck masses. The tularemia outbreak in central Black Sea region, Turkey in 2004 changed our approach to a patient presenting with neck mass.Archives of Oto-Rhino-Laryngology 01/2009; 266(10):1595-8. · 1.29 Impact Factor
Article: Tularemia in children.[Show abstract] [Hide abstract]
ABSTRACT: Tularemia, an infection caused by the coccobacilus Francisella tularensis, can be a difficult disease process to diagnose and treat. The aim of this study was to evaluate an epidemic of tularemia in Bursa. In this study, we included only pediatric cases. All the cases were diagnosed on clinical and serological grounds. During an epidemic of tularemia in a village of Bursa on December 2004, 70 people (60 adults, 10 children) fell ill. In children with tularemia, the oropharyngeal form predominated which was diagnosed 70% of cases. Most of the patients (80%) who had older than 10 years old, were treated with doxycycline. All patients recovered without complications. The epidemic was thought to be waterborne. The vehicle of the infections was inadequately treated water which was used by the patient in the village.The Indian Journal of Pediatrics 10/2008; 75(11):1129-32. · 0.72 Impact Factor