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Year : 2022  |  Volume : 14  |  Issue : 3  |  Page : 120-121

Complicated ulceroglandular tularemia

Clinical Center of Serbia, University Hospital for Infectious and Tropical Diseases, Belgrade, Serbia

Correspondence Address:
Dr. Uroš Karić
Bulevar Oslobodjenja 16, Belgrade 11000
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jgid.jgid_82_21

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A 52-year-old woman presented with a tender swelling in the right axilla, fever, a headache, nausea, and general weakness. On examination, she was found to have lymphangitis on the right arm and red papules on the 1st and 2nd fingers of the right hand. She had had prepared wild rabbit stew 5 days before disease onset. Serology and an ultrasound of the right axilla confirmed the diagnosis of ulceroglandular tularemia. The lymphadenitis did not resolve after streptomycin treatment so an incision was made and 30 cc of purulent fluid drained. Over the course of the next 3 months, the fluid continued to drain. A radiographic fistulography was performed and it revealed a short main channel with a few long channels of varying caliber branching out from it, all terminating in a conglomerate of necrotic axillary lymph nodes. The lesions healed spontaneously and completely over the following 12 months without additional antibiotic therapy. Radiographic fistulography can help plot the course of the fistula/fistulas and demonstrate the anatomic features of the lesion in resource poor settings.

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008