This case report details the clinical manifestation and course of glandular tularemia, an uncommon but significant cause of cervical lymphadenopathy in children. We discuss the unique attributes of this disease along with appropriate steps that lead to early identification of the organism and effective treatment. The potential use of the organism as a bioterrorism agent is another interesting aspect of this entity.
References
1.
FrancisE.Tularemia. JAMA1925;84:1243–50.
2.
LevyPD, ChiangWK. Update of emerging infections: News from the Centers for Disease Control and Prevention. Ann Emerg Med2002;40:181–4.
3.
CravenRB, BarnesAM. Plague and tularemia. Infect Dis Clin North Am1991;5:165–75.
4.
Doan-WigginsL.Tick-borne diseases. Emerg Med Clin North Am1991;9:303–25.
5.
RobsonCD. Imaging of granulomatous lesions of the neck in children. Radiol Clin North Am2000;38:969–77.
6.
DennisDT, InglesbyTV, HendersonDA, Tularemia as a biological weapon. JAMA2001;285:2763–73.
7.
PattHA, FeiginRD. Diagnosis and management of suspected cases of bioterrorism: A pediatric perspective. Pediatrics2002;109:685–92.
8.
LabayruC, PalopA, Lopez-UrrutiaL, [Francisella tularensis: Update on microbiological diagnosis after an epidemic outbreak]. Enferm Infecc Microbiol Clin1999;17:458–62.
9.
JohanssonA, BerglundL, ErikssonU, Comparative analysis of PCR versus culture for diagnosis of ulceroglandular tularemia. J Clin Microbiol2000;38:22–6.
10.
BerdalBP, MehlR, HaaheimH, Field detection of Francisella tularensis. Scand J Infect Dis2000;32:287–91.
11.
IkahcimoI, SyrjalaH, KarhukorpiJ, In vitro antibiotic susceptibility of Francisella tularensis isolated from humans and animals. J Antimicrob Chemother2000;46:287–90.
12.
JohanssonA, BerglundL, GotheforsL, Ciprofloxacin for treatment of tularemia in children. Pediatr Infect Dis J2000;19:449–53.
13.
MarkowitzLE, HynesNA, de la CruzP, Tick-borne tularemia. An outbreak of lymphadenopathy in children. JAMA1985;254:2922–5.
