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Neck Mass: Tularemia Misdiagnosed as a Possible Malignancy
Élodie Gemme1, Philippe Lagacé-Wiens1,2, Yoav Keynan1,3
1Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Summary
Tularemia, a zoonotic disease caused by Francisella tularensis, requires prompt diagnosis. A bear hunter
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Tularemia is a zoonotic disease caused by Francisella tularensis, prevalent in the Northern Hemisphere.
- Diverse animal reservoirs and transmission routes necessitate thorough exposure history.
- Fever, skin eruption, and lymphadenopathy can indicate tularemia.
Observation:
- Francisella tularensis is a Risk Group 3 pathogen and Category A bioterrorism agent.
- Potential for aerosolization, low infectious dose, and high fatality rates (2-60%) pose risks to laboratory personnel.
- A case of delayed tularemia diagnosis in a bear-hunting guide highlights awareness challenges.
Findings:
- A 65-year-old bear-hunting guide presented with tularemia.
- Management was delayed due to insufficient awareness of the disease.
- Diagnosis was confirmed via neck mass biopsy, leading to full recovery with antibiotics.
Implications:
- Increased awareness of tularemia is crucial for healthcare providers, especially in endemic areas or with relevant occupational exposures.
- Safer referral practices and improved laboratory communication are essential for handling potentially infectious samples.
- Prompt diagnosis and antibiotic treatment are vital for favorable outcomes in tularemia cases.
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