Agca Meltem, Duman Dildar, Sulu Ebru, Ozbaki Fatma, Barkay Orcun, Ozturk Derya, Yarkin Tulay
Department of Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, GATAHaydarpasa Training Hospital, Istanbul, Turkey.
J Coll Physicians Surg Pak. 2017 Sep;27(9):574-576.
Tularemia is a zoonotic infection which is caused by gram negative coccobacilli, Francisella tularensis. The disease occurs after contact with blood and body fluids of infected animals, bites and ingestion of infected food and water. Although it commonly presents with skin lesions, there may also be serious organ involvements. A55-year woman was consulted for presumptive diagnosis of tuberculosis. Multiple lymphadenopathy in right cervical area was present on physical examination. Pleural effusion on left side was detected with computed tomography. In detailed history, knowledge of a family member with the diagnosis of tularemia was obtained. Both of them had the history of contact with infected animals. Diagnosis of tularemia was confirmed with microagglutination test. With this patient who was initially presumptively diagnosed as tuberculosis, we aim to draw attention to diagnosis of tularemia in the presence of pleuropnemonia and peripheral lymphadenopathy and emphasize importance of detailed patient history.
兔热病是一种人畜共患感染病,由革兰氏阴性球杆菌土拉弗朗西斯菌引起。该疾病在接触受感染动物的血液和体液、被叮咬以及摄入受感染的食物和水后发生。虽然它通常表现为皮肤病变,但也可能有严重的器官受累情况。一名55岁女性因疑似肺结核前来咨询。体格检查发现右侧颈部有多处淋巴结病。计算机断层扫描检测到左侧胸腔积液。在详细询问病史时,得知有一名家庭成员被诊断为兔热病。两人都有接触受感染动物的病史。通过微量凝集试验确诊为兔热病。对于这名最初被疑似诊断为肺结核的患者,我们旨在提醒注意在存在胸膜肺炎和外周淋巴结病的情况下兔热病的诊断,并强调详细询问患者病史的重要性。