¹⁸F-FDG PET/CT Findings in Glandular Tularemia

Area of Science:

• Infectious Diseases
• Medical Imaging
• Microbiology

Background:

• Tularemia is a zoonotic disease caused by Francisella tularensis, often transmitted by ticks.
• Glandular tularemia presents with nonspecific symptoms like fever and swollen lymph nodes, complicating diagnosis.
• Diagnostic uncertainty can delay appropriate treatment for tularemia.

Purpose of the Study:

• To describe a challenging case of glandular tularemia.
• To illustrate the utility of 18F-FDG PET/CT in diagnosing tularemia.
• To highlight the importance of considering tularemia in patients with relevant exposure history.

Main Methods:

• Case report of a 47-year-old woman with suspected tularemia after a tick bite.
• Diagnostic workup included lymph node biopsy, PCR, serology, and 18F-FDG PET/CT.
• Analysis of imaging findings in conjunction with microbiological results.

Main Results:

• The 18F-FDG PET/CT scan revealed high metabolic activity in the inguinal region, suggestive of abscesses.
• Diagnosis was confirmed by positive PCR and serology for Francisella tularensis.
• The patient presented with classic symptoms of fever, fatigue, night sweats, and lymphadenopathy.

Conclusions:

• Glandular tularemia can present insidiously, posing diagnostic challenges.
• 18F-FDG PET/CT can be a valuable tool in identifying infectious foci in suspected tularemia cases.
• Early diagnosis and appropriate imaging are crucial for managing tularemia effectively.