A challenging case of Francisella Tularensis: teenager's massive lymphoadenopathy caused by an uncommon infectious disease.
Tularemia is a potentially fatal, multisystemic infectious disease of humans and some animals caused by Fran- cisella Tularensis bacteria. Up to six forms of clinical manifestations of tularemia have been identified, ulcer- oglandular tularemia being the most common form. Up- per airway manifestatio...
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| Main Authors: | , , , , , , , , |
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| Format: | Book |
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Pediatric Anesthesia and Critical Care Journal,
2022-06-01T00:00:00Z.
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| Summary: | Tularemia is a potentially fatal, multisystemic infectious disease of humans and some animals caused by Fran- cisella Tularensis bacteria. Up to six forms of clinical manifestations of tularemia have been identified, ulcer- oglandular tularemia being the most common form. Up- per airway manifestations of tularemia include tonsillar hypertrophy and pharyngitis, accompanied by cervical lymphadenopathies. Anatomical alterations of the cervi- cal district represent an additional risk in airways man- agement. Between 2016 and 2019, only three cases of tu- laremia have been described in Italy, but some authors consider Tularemia underreported, especially in Europe. We describe a case of a 17-year-old boy who presented to our clinic with massive cervical left lymphadenopathy and enlargement of the ipsilateral palatine tonsil associ- ated with fever. The symptoms persisted after antibiotic and corticosteroid treatment. To exclude a lymphoprolif- erative disease, a full body CT scan with contrast was performed, showing multiple cervical bilateral lymphadenopathies, especially on the left side and hyper- trophy of the left palatine tonsil and splenomegaly. The biopsy of the left tonsil, performed under general anes- thesia, demonstrated a granulomatous inflammation. A more accurate reconstruction of the patient history re- vealed domestic presence of rabbits. Therefore, serologic and molecular tests for F. Tularensis were performed, with positive results. Proper antibiotic treatment was ad- ministered with gradual and complete symptoms regres- sion. |
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| Item Description: | 10.14587/paccj.2022.5 2281-8421 |