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Case report
Paediatric oropharyngeal tularaemia requiring surgical intervention
  1. Amina Nemmour1,
  2. Adzreil Bakri1,2,
  3. Claude A Fischer1 and
  4. Yves Brand1,3
  1. 1 Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland
  2. 2 Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia
  3. 3 University Basel, Basel, Switzerland
  1. Correspondence to Dr Yves Brand, yves.brand{at}


Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Francisella tularensis.1 Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Subsequently, the patient fully recovered from the illness and the follow-up was negative for relapse.

  • otolaryngology/ent
  • infectious diseases
  • paediatrics

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  • Contributors AN and AB: data acquisition and analysis, drafting and design of article and final approval of article. CAF: critical revision of article and final approval of article. YB: data interpretation, drafting and design of article, critical revision and final approval of article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.