Khan Fiza, Hashmi Md Foorquan, Ohan Goulia, Asoyan Vigen, Hovhannisyan Alvard
Department of General Medicine, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, ARM.
Department of Epidemiology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, ARM.
Cureus. 2025 May 19;17(5):e84439. doi: 10.7759/cureus.84439. eCollection 2025 May.
Tularemia, a life-threatening zoonotic infection caused by , is a significant public health concern. Diagnosis can be challenging due to nonspecific symptoms, including fever, tonsillitis, and lymphadenopathy. We present the case of a 48-year-old male from a rural area of the Tavush region admitted to our hospital, initially presenting with left-sided tonsillitis, followed by the development of enlarged lymph nodes in the neck and a mild fever. Despite initial treatment with amoxicillin, tularemia was confirmed through positive serological tests, including antibody titers of 1:400 by the volumetric agglutination method and elevated IgM (0.74) and IgG (0.51) levels by enzyme-linked immunosorbent assay (ELISA). Treatment with ciprofloxacin was initiated, leading to the resolution of fever but subsequent lymph node suppuration. Prompt drainage and a course of doxycycline resulted in patient healing and discharge. This case underscores the importance of considering tularemia in patients presenting with tonsillitis, fever, and lymphadenitis, particularly in endemic and rural areas, and emphasizes the necessity of timely diagnosis and early treatment to prevent complications and economic burdens.
兔热病是一种由……引起的危及生命的人畜共患感染病，是一个重大的公共卫生问题。由于其症状不具特异性，包括发热、扁桃体炎和淋巴结病，诊断可能具有挑战性。我们报告了一例来自塔武什地区农村的48岁男性病例，该患者入住我院，最初表现为左侧扁桃体炎，随后颈部淋巴结肿大并伴有低热。尽管最初使用阿莫西林进行治疗，但通过阳性血清学检测确诊为兔热病，包括通过容积凝集法测得抗体滴度为1:400，以及通过酶联免疫吸附测定（ELISA）测得IgM（0.74）和IgG（0.51）水平升高。开始使用环丙沙星进行治疗，发热症状得到缓解，但随后淋巴结出现化脓。及时引流并给予多西环素疗程治疗后，患者痊愈出院。该病例强调了在出现扁桃体炎、发热和淋巴结炎的患者中考虑兔热病的重要性，特别是在流行地区和农村地区，并强调了及时诊断和早期治疗以预防并发症和经济负担的必要性。
