Tularaemia presenting as parapharyngeal abscess: case presentation

• DOI: 10.1017/s0022215112000096
• Publication Date: 2012-03-09T06:26:14Z
• Authors: S Koc; L Gürbüzler; H Yaman; A Eyibilen; N Salman; A Ekici
• Keywords: Sore throat; Pyriform Sinus; Neck mass; Retropharyngeal Abscess; Parapharyngeal space

Abstract Objective: We report an extremely rare case of the oropharyngeal form tularaemia, causing a parapharyngeal abscess. Case report: A 48-year-old woman presented with fever, sore throat, breathing difficulty and right-sided neck swelling. This mass had previously been treated penicillin without response, already surgically drained once in another hospital. On physical examination, tonsils were exudative hypertrophic pharynx was hyperaemic. fluctuant, 4 × cm seen on endoscopic originating from left area protruding towards pyriform sinus, partly obstructing airway. Microagglutination test antibody titres for Francisella tularensis positive (1/1280). The patient healed completely after definitive drainage abscess antimicrobial therapy 14 days (streptomycin, 2 1 g intramuscularly). Conclusion: Tularaemia should be considered differential diagnosis patients presenting tonsillopharyngitis, cervical lymphadenitis who do not respond to treatment penicillin, even if they live endemic region.