Oculoglandular syndrome caused by Francisella tularensis

Oculoglandular syndrome developed in a 9-year-old boy with a recent history of tick bites and minor eye trauma. Francisella tularensis was isolated on chemically supplemented chocolate agar from a swab of a conjunctival ulcer and an aspirate of a preauricular lymph node, confirming the diagnosis of tularemia. In addition, a rise in agglutination titer to the pathogen was detected in paired sera. The differential diagnosis of oculoglandular syndrome is discussed, with emphasis on the clinical characteristics which led to the diagnosis of tularemia.