Oropharyngeal tularemia in a patient presenting with an infected branchial cleft anomaly

Abstract

We present a case of oropharyngeal tularemia manifesting as a neck mass and pharyngitis in a 7-year old female. The patient presented with pharyngitis, fatigue, and high fevers. Physical exam demonstrated 4+ exudative tonsils and a large right neck mass concerning for an infected branchial cleft anomaly. A review of the literature is discussed, and the manifestations of tularemia in the head and neck are reviewed. The clinical features of this case are most consistent with a superinfected second branchial cleft cyst, rather than an infected lymph node as has been reported in past cases of oropharyngeal tularemia.