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[Mind the bat: Rare Infection as Lung Cancer Mimic - a Case Report]
Lisa Larcher1, Vera Graup2, Dirk Wagenetz3
1Stadtspital Zürich Triemli: Stadtspital Zurich Triemli, SWITZERLAND, Zürich.
Deutsche Medizinische Wochenschrift (1946)
|August 10, 2026
Summary
Pulmonary tularemia, a rare bacterial infection, can mimic lung cancer on CT scans. Early diagnosis through patient history and PCR testing is crucial for effective treatment and avoiding invasive procedures.
Area of Science:
- Infectious Diseases
- Pulmonology
- Radiology
Background:
- Pulmonary tularemia is a rare zoonotic disease caused by Francisella tularensis.
- It can present with symptoms mimicking lung cancer, leading to diagnostic challenges.
Purpose of the Study:
- To highlight the importance of considering pulmonary tularemia in the differential diagnosis of lung cancer.
- To emphasize the role of patient history and specific diagnostic tests in identifying this infection.
Main Methods:
- Case presentation of a patient with symptoms suggestive of lung malignancy.
- Diagnostic workup including Chest CT, bronchoscopy, EBUS-TBNA, thoracoscopic biopsy, PCR, and serology.
- Treatment with gentamicin and doxycycline.
Main Results:
- Chest CT showed a lesion suspicious for lung carcinoma with mediastinal lymphadenopathy.
- Biopsies revealed inflammation, not malignancy.
- PCR and serology confirmed Francisella tularensis, establishing the diagnosis of pulmonary tularemia.
- Patient symptoms resolved with appropriate antibiotic therapy.
Conclusions:
- Pulmonary tularemia can present radiographically similar to lung cancer.
- A thorough patient history, including potential exposure risks, is vital.
- Early identification and treatment of pulmonary tularemia can prevent unnecessary invasive procedures and ensure favorable outcomes.