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A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

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Tularaemia presenting as parapharyngeal abscess: case presentation.

S Koc¹, L Gürbüzler, H Yaman

¹Department of Otorhinolaryngology, Gaziosmanpasa University School of Medicine, Tokat, Turkey. drsemakoc@gmail.com

The Journal of Laryngology and Otology

|March 10, 2012

Summary

Oropharyngeal tularaemia is rare and can cause a parapharyngeal abscess. Consider this infection in patients with severe throat symptoms unresponsive to penicillin, even outside endemic areas.

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Last Updated: May 24, 2026

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

Published on: October 25, 2024

Area of Science:

Infectious Diseases
Otolaryngology
Microbiology

Background:

Tularaemia, a zoonotic disease caused by Francisella tularensis, typically presents with fever, lymphadenopathy, and localized symptoms depending on the route of infection.
The oropharyngeal form is less common but can lead to significant local complications, including abscess formation.
Prompt and accurate diagnosis is crucial for effective management and preventing severe outcomes.

Observation:

A 48-year-old woman presented with symptoms suggestive of severe tonsillopharyngitis, including fever, sore throat, dyspnea, and a neck mass.
The patient had a history of unsuccessful penicillin treatment and prior surgical drainage for the neck swelling.
Endoscopic examination revealed a parapharyngeal abscess causing airway compromise, with positive serological titers for Francisella tularensis.

Findings:

The case highlights an unusual presentation of oropharyngeal tularaemia manifesting as a parapharyngeal abscess.
Successful treatment involved surgical drainage of the abscess and a 14-day course of streptomycin.
The patient experienced a complete recovery following appropriate antimicrobial therapy.

Implications:

Tularaemia should be included in the differential diagnosis for patients with tonsillopharyngitis, cervical lymphadenitis, or parapharyngeal abscesses, particularly those refractory to standard antibiotic treatment.
Clinicians should maintain a high index of suspicion for tularaemia, even in non-endemic regions, especially when initial treatments fail.
This case underscores the importance of considering rare infectious etiologies in complex head and neck presentations.