Institute of Clinical Microbiology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic.
Clinic of Infectious Diseases, University Hospital, Sokolská 581, 50005 Hradec Králové, Czech Republic.
Ticks Tick Borne Dis. 2022 Mar;13(2):101893. doi: 10.1016/j.ttbdis.2021.101893. Epub 2021 Dec 25.
Although Francisella (F.) tularensis is a well-described and understood zoonotic pathogen, its importance in Central Europe is relatively minor and, as such, tularaemia may be missed in the differential diagnosis. The annual incidence of tularaemia in the Czech Republic is relatively stable with up to 100 reported cases per year, except in the epidemic years 1998 and 1999 with 225 and 222 reported cases, respectively. It is, however, higher in comparison with the neighbouring countries. The common route of transmission in Central Europe is handling infected animals. Tularaemia is not commonly recognized as a tick-borne disease. Here we report two rare cases of a tick bite-associated ulceroglandular form of tularaemia in 2.5-year-old and 6.5-year-old children presenting with cervical lymphadenopathy. The unusual and interesting features of those cases are the young age and relatively uncommon route of transmission suggesting possible changes in the epidemiology of tularaemia in the Czech Republic. Therefore, the infection with F. tularensis should be considered in the differential diagnosis after a tick bite even in infants.
尽管土拉弗朗西斯菌（F.）是一种描述详尽、研究透彻的人畜共患病病原体，但在中欧，其重要性相对较低，因此在鉴别诊断中可能会忽略土拉菌病。捷克共和国的土拉菌病年发病率相对稳定，每年报告病例多达 100 例，但在 1998 年和 1999 年的流行年份，分别报告了 225 例和 222 例。然而，与邻国相比，其发病率更高。在中欧，常见的传播途径是接触受感染的动物。土拉菌病通常不被认为是一种蜱传疾病。在此，我们报告了两例罕见的 2.5 岁和 6.5 岁儿童的蜱咬相关性溃疡腺型土拉菌病病例，表现为颈部淋巴结病。这些病例的不同寻常和有趣之处在于发病年龄较小，且传播途径相对罕见，这表明捷克共和国的土拉菌病流行病学可能发生了变化。因此，即使是婴儿，在被蜱叮咬后也应考虑土拉弗朗西斯菌感染的鉴别诊断。
