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Oropharyngeal tularemia with skin manifestation: Sweet’s syndrome


Authors: B. Stárková;  Richard Salzman
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN Olomouc
Published in: Otorinolaryngol Foniatr, 71, 2022, No. 4, pp. 225-229.
Category: Case Reports
doi: https://doi.org/10.48095/ccorl2022225

Overview

The authors present a case report of a patient with unilateral tonsillitis and severe non-specific inflammatory response not responding to anti-bio­tic therapy. Along with persistent local and systemic symptoms, the patient also developed skin exanthema and cervical lymphadenopathy. The definitive dia­gnosis of oropharyngeal tularemia was confirmed after several weeks, based on serological and histological findings. Finally, the targeted antibio­tic therapy led to rapid symptom resolution. The authors describe an unusual combination of the dia­gnoses, which resulted in a prolonged and initially unsuccessful therapy. Symptoms resembling to tonsillitis, which persist despite the use of antibio­tics, should lead to reconsideration of suspected dia­gnosis.

Keywords:

tularemia – lymphadenopathy – tonsillitis – Sweet’s syndrome


Sources

1. Prokšová M, Bavlovič J, Klimentová J et al. Tularémie – zoonóza s rizikem bio­terorismu. Epidemiol Mikrobio­l Imunol 2018; 68 (2): 82–89.

2. Sweet RB. An acute febrile neutrophilic dermatosis. Br J Dermatol 1964; 76 (8–9): 349–356. Doi: 10.1111/j.1365-2133.1964.tb14541.x.

3. Boudyšová M, Ettler K, Podhola M et al. Akutní febrilní neutrofilní dermatóza – Sweetův syndrom. Čas Lék čes 2012; 151 (7): 359–361.

4. Rochet NM, Chavan RN, Cappel MA et al. Sweet syndrome: Clinical presentation, associations, and response to treatment in 77 patients. J Am Acad Dermatol 2013; 69 (4): 557–564. Doi: 10.1016/j.jaad.2013.06.0023.

5. Heath MS, Ortega-Loayza AG. Insights Into the Pathogenesis of Sweet‘s Syndrome. Front Immunol 2019; 10: 414. Doi: 10.3389/ fimmu.2019.00414.

6. Ruiz AIB, González A, Miranda A et al. Sweet‘s syndrome associated with francisella tularensis infection. Int J Dermatol 2002; 40 (12): 791–792. Doi: 10.1046/j.1365-4362.2001.01162.x.

7. Mualla P, Haydar PA, İsmail Ö et al. Erythema nodosum and Sweet’s syndrome in patients with glandular tularemia. Int J Dermatol 2011; 50 (7): 866–869. Doi: 10.1111/j.1365-46 32.2010.04647.x.

8. Polat M, Karapınar T, Sırmatel F. Dermatolo­gical aspects of tularaemia: a study of 168 cases. Clin Exp Dermatol 2018; 43 (7): 770–774. Doi: 10.1111/ced.13548.

9. SZÚ. Infekce v ČR – ISIN. 2022 [online]. Dostupné z: http: //www.szu.cz/publikace/data/ infekce-v-cr.

10. Špačková M, Orlíková H, Fabiánová K et al. 29. Pečenkovy epidemiologické dny v Plzni, 2020. Epidemiol Mikrobio­l Imunol 2020; 69 (4): 195–197.

11. Karakas A, Coskun O, Artuk C et al. Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey. J Infect Dev Ctries 2014; 8 (8): 994–999. Doi: 10.3855/jidc. 4332.

12. Celebi G, Baruönü F, Ayoğlu F et al. Tularemia, a reemerging disease in northwest Turkey: epidemiological investigation and evaluation of treatment responses. Jpn J Infect Dis 2006; 59 (4): 229–234.

13. Zavázalová Š, Jirák P, Syrůček M et al. Castlemanova choroba – Mimicking a malignant lymphoma. Otorinolaryngol Foniatr 2014; 63 (4): 246–250.

14. Chovanec M, Komínek P, Zeleník K. Příručka pro praxi: Diferenciální dia­gnostika krčního uzlinového syndromu. Praha: Česká společnost otorinolaryngologie a chirurgie hlavy a krku, 2014.

15. Markoc F, Koseoglu RD, Koc S et al. Tularemia in Differential Dia­gnosis of Cervical Lymphadenopathy: Cytologic Features of Tularemia Lymphadenitis. Acta Cytol 2014; 58 (1): 23–28. Doi: 10.1159/000355869.

16. Windfuhr JP, Toepfner N, Steffen G et al. Clinical practice guideline: tonsillitis I. Dia­gnostics and nonsurgical management. Eur Arch Otorhinolaryngol 2016; 273 (4): 973–987. Doi: 10.1007/s00405-015-3872-6.

17. McEwan J, Basha S, Rogers S et al. An unusual presentation of cat-scratch disease. J Laryngol Otol 2001; 115 (10): 826–828. Doi: 10.1258/0022215011909071.

18. Arikan OK, Koc C, Bozdogan O. Tularemia presenting as tonsillopharyngitis and cervical lymphadenitis: a case report and review of the literature. Eur Arch Otorhinolaryngol 2003; 260 (6): 298–300. Doi: 10.1007/s00405-002-05 65-8.

19. Dlugaiczyk J, Harrer T, Zwerina J et al. Oropharyngeal tularemia – a differential dia­gnosis of tonsillopharyngitis and cervical lymphadenitis. Wien Klin Wochenschr 2010; 122: 110–114. Doi: 10.1007/s00508-009-1274-8.

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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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