|Beitragstitel||Paediatric oropharyngeal tularaemia requiring surgical intervention|
Paediatric oropharyngeal tularaemia requiring surgical intervention
Tularaemia is a zoonosis that often causes unspecific symptoms. The incidence of tularaemia has almost tripled in Switzerland in the last decade to 1.33/100`000 in 2018. Our aim is to raise awareness of this re-emerging disease.
Material & Method
We present a case of a 5-year old boy with oropharyngeal tularaemia requiring surgical intervention despite an adequate antibiotic treatment. Furthermore, we discuss the aetiology, diagnosis and differential diagnosis of tularaemia.
Tularaemia is caused by the bacterium Francisella tularensis. Patients often show non-specific symptoms, which causes a delay in diagnosis. In our case the patient initially presented with a pharyngotonsillitis and was treated with Co-Amoxicillin. Further investigations were initiated since his condition did not improve. Serologic tests were positive for tularaemia. He had a protracted course despite an antibiotic treatment according to WHO guidelines. He developed a parapharyngeal abscess and a necrotic lymph node that both required surgical intervention. After another antibiotic treatment he fully recovered.
Tularaemia is a re-emerging zoonosis. In case of lymphadenopathy and fever not responding to betalactam-antibiotic treatment tularaemia is an important potentially lethal differential diagnosis. A high index of suspicion is crucial to avoid delay in diagnosis and treatment which can lead to complications requiring surgical intervention.
Amina Nemmour (Erstautor), Adzreil Bin Bakri, Claude Fischer, Yves Brand
Institutionen aller Autoren:
Kantonsspital Graubünden, HNO-Klinik, Chur