Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey

  • Ahmet Karakas Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Omer Coskun Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Cumhur Artuk Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Umit Savasci Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Hanefi Cem Gul Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Gurkan Mert Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Ismail Yasar Avci Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Bulent Ahmet Besirbellioglu Gulhane Military Medical Academy, Etlik, Ankara, Turkey
  • Can Polat Eyigun Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Keywords: Francisella tularensis, tularemia, oropharyngeal tularemia, cervical mass, Turkey

Abstract

Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results.

Methodology: Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded.

Results: Twelve of the patients included in this study were males. The average age of the patients was 32.1±17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6±6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare institutions previously. However, despite the treatment, cervical lymphadenopathy had developed in these cases. Patients were given streptomycin, doxycycline, and ciprofloxacin monotherapy or in combination. Ten of the cases fully recovered, while five required surgical lymph node drainage. Spontaneous drainage occurred in the single remaining case.

Conclusions: Turkey is considered to be an endemic country with regards to tularemia. Prompt diagnosis and proper treatment of the disease is imperative in providing cure. Since it can be potentially confused with tuberculous lymphadenitis, differential diagnosis is vital. Patients presenting with a condition of tonsillopharyngitis in endemic areas must be carefully monitored.

Author Biographies

Ahmet Karakas, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
M.D., Assist Prof. in Deparment of Infectious Diseases and Clinical Microbiology
Omer Coskun, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Cumhur Artuk, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Umit Savasci, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology,
Hanefi Cem Gul, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology,
Gurkan Mert, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Ismail Yasar Avci, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Bulent Ahmet Besirbellioglu, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Can Polat Eyigun, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
Department of Infectious Diseases and Clinical Microbiology
Published
2014-08-13
How to Cite
1.
Karakas A, Coskun O, Artuk C, Savasci U, Gul HC, Mert G, Avci IY, Besirbellioglu BA, Eyigun CP (2014) Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey. J Infect Dev Ctries 8:994-999. doi: 10.3855/jidc.4332
Section
Original Articles