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Tularaemia of middle ear with suppurative lymphadenopathy and retropharyngeal abscess

Published online by Cambridge University Press:  02 March 2009

R Gürkov ,
U Kisser ,
W Splettstösser ,
M Hogardt  and
E Krause
R Gürkov*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University of Munich, Germany
U Kisser
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University of Munich, Germany
W Splettstösser
Affiliation:
Institute of Microbiology, Federal Armed Forces Medical Academy Munich, Germany
M Hogardt
Affiliation:
Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Germany
E Krause
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University of Munich, Germany
*
Address for correspondence: Dr Robert Gürkov, Department of Otorhinolaryngoloy Head and Neck Surgery, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany. Fax: +49 89 7095 6869 E-mail: robert.guerkov@med.uni-muenchen.de
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Abstract

Objective:

We report an extremely rare case of otitis media due to Francisella tularensis, complicated by multiple suppurative cervical lesions and a lasting conductive hearing loss.

Case report:

A young woman presented with otitis media, several neck swellings and a retropharyngeal swelling. Polymerase chain reaction testing of aspirated fluid and serology confirmed the diagnosis of tularaemia. Specific antibiotic therapy initiated six weeks after the onset of initial symptoms did not resolve the disease, and open surgical drainage was necessary.

Conclusions:

Otitis media unresponsive to conventional therapy and accompanied by unusually pronounced lymphadenopathy should prompt the clinician to consider tularaemia as a differential diagnosis, in order to initiate timely, specific therapy.

Keywords

Francisella TularensisOtitis MediaLymphadenitisOtolaryngology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1252 - 1257
Copyright
Copyright © JLO (1984) Limited 2009

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