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[Fever and a mediastinal mass--infection or malignancy?]
Jouni Hedman1, Asko Järvinen, Maija Halme
1Keski-Suomen keskussairaala, keuhkosairauksien klinikka.
Duodecim; Laaketieteellinen Aikakauskirja
|February 26, 2013
Summary
A seventy-seven-year-old woman with a history of osteomyelitis presented with antibiotic-resistant fever. Tularemia was diagnosed after ruling out other conditions and confirming with serologic testing.
Area of Science:
- Infectious Diseases
- Medical Microbiology
Background:
- A seventy-seven-year-old female patient with a history of osteomyelitis presented with a persistent, antibiotic-resistant fever.
- Differential diagnoses included unusual infections, autoimmune diseases, and malignancy.
Observation:
- Computed tomography (CT) scan revealed a mediastinal mass, prompting a mediastinoscopy.
- Histological examination indicated a granulomatous infection, but tuberculosis was excluded.
Findings:
- The patient showed a favorable response to standard antibiotic treatment.
- Serologic testing confirmed the diagnosis of tularemia.
Implications:
- This case highlights the importance of considering tularemia in patients with unexplained fevers and mediastinal masses, especially with a relevant exposure history.
- Prompt diagnosis and treatment of tularemia are crucial for favorable outcomes.
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