Head and Neck Manifestations of Tularemia in Tyrol (Austria): A Case Series.

Tularemia is a rare zoonosis caused by the bacterium . In the head and neck region, it can manifest as cervical lymphadenopathy. Despite intensive therapy with various antibiotics, there is often a prolonged medical course. In this paper, all documented cases of tularemia in the head and neck region at the Medical University of Innsbruck (Austria) are analyzed and the results compared with the literature. A retrospective analysis of all patients diagnosed with tularemia at the Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck (Austria), was performed. Tularemia was diagnosed using a serologic agglutination antibody test. Thirteen patients with tularemia presented at the Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck (Austria), between 2010 and 2024. In 10 patients (10/13; 77%), animal contact or an insect bite was the suspected cause. The mean time from the onset of the first symptoms to diagnosis was 36 ± 15 days. The therapy took a mean of 5 ± 2 months until the last follow-up. On average, the patients were treated with 4 ± 1 different antibiotics. The median duration of hospital stay was 13 days (range: 0-36). In addition, a median of 9 (range: 2-20) further outpatient check-ups with several neck ultrasounds were carried out. Also, 10 patients (10/13; 77%) received a diagnostic and/or therapeutic surgical intervention. Tularemia is a rare infectious disease with a prolonged diagnostic and therapeutic course. Screening for tularemia should be performed in cases of cervical lymphadenopathy, especially if empirical antibiotic treatment has been ineffective or if there is a specific medical history.