We would like to thank Yusuf Kemaloglu for his interest in our article: Kizil et al. [2]. Dr. Kemaloglu [1] deeply investigated and kindly informed us about historical roots of tularemia in Turkey. We appreciate the contribution of Dr. Kemaloglu from a historical perspective. Since the first biological warfare as Dr. Kemaloglu stated, tularemia agent Francisella tularensis is still regarded as a potential biological weapon [1]. However, in war times, tularemia outbreaks are encountered due to poor hygiene and increased exposure to reservoirs and vectors. As a result, instead of biological attacks, war itself may be the primary cause of outbreaks. Although our aim was not to define an outbreak or a regional feature of the disease, his prediction was right about homelands of the patients. Most of the patients (10 patients) were from the same village of Corum province (Central Anatolia) and one patient had a travel history to that village. In addition, the patients also stated that the disease was present in many other inhabitants of the village which reflects an outbreak. The cause of the outbreak was probably contamination of drinking water source of the village by rats. As we have reported in our paper, the glandular form is the most common one in our series, and only 36.8 % presented with either oropharyngeal or ocular lesions [2]. Therefore, as Dr. Kemaloglu stated, this form could be a new burden of the disease without any entrypoint lesions. Some recent studies reporting high glandular form incidence rates also support this hypothesis [3, 4]. Hence, we think that the source of infection still could be spring water in rural areas, although only 31.6 % had oropharyngeal forms. Our primary treatment choice was medical treatment and surgical drainage of suppurated adenopathies, but surgically or spontaneously drained lymph nodes heal with extensive scar formation. In certain cases with long-lasting and large neck mass with overlying skin involvement, we thought that a comprehensive surgical resection of the involved skin along with the diseased lymph nodes may be a more effective solution. Therefore, a group of patients with a mean symptom duration of approximately 3 months were treated with superselective neck dissection and the results were quite satisfactory. This management pattern is comparable to the surgical treatment of atypical mycobacterial neck infections which are also resistant to medical therapy. We concluded that in patients with extensive neck involvement, immediate and effective results could be achieved with excision of involved skin and superselective neck dissection.