Oropharyngeal tularemia: a case report

Abstract

Tularemia is a zoonotic disease caused by the gram-negative, aerobic coccobacillus Francisella tularensis. It transmits with the body secretions of the infected rodents, ingestion of the food contaminated with these fluids and bites of infected insects. Ulceroglandular, glandular, oculoglandular, oropharyngeal, typhoidal and pneumonic types may be observed based on the entrance route to the body and location of the bacteria. Although the clinical presentation may vary, oropharyngeal tularemia is the most commonly seen clinical form in Turkey. Otolaryngologists generally experience tularemia with membranous tonsillopharyngitis and cervical lymphadenopathy. Oropharyngeal tularemia should be considered in the differential diagnosis of patients with tonsillopharyngitis who are refractory to penicillin therapy. In this article, we present a 42-years-old female case of oropharyngeal tularemia who was initiated with penicillin therapy due to tonsillopharyngitis and cervical lymphadenitis and remained unresponsive to the treatment. Clinical, laboratory and radiological findings of the patient were evaluated and discussed in the light of similar cases in the literature.