Hepatic abscess complicating ulceroglandular tularemia

Area of Science:

• Infectious Diseases
• Hepatology
• Microbiology

Background:

• Tularemia is a bacterial zoonotic disease caused by Francisella tularensis.
• Ulceroglandular tularemia is the most common form, characterized by skin ulcers and lymphadenopathy.
• Hepatic involvement in tularemia is uncommon, especially with prompt antibiotic treatment.

Observation:

• A patient presented with classic ulceroglandular tularemia symptoms.
• Ultrasound revealed a solitary hepatic abscess.
• This finding occurred despite the early stages of the disease and presumed effective therapy.

Findings:

• Hepatic tularemia, though uncommon, can manifest early in the disease course.
• A solitary liver abscess was identified as a complication.
• Increased serum hepatic enzymes may be the only presenting sign of hepatic tularemia.

Implications:

• This case highlights the potential for early liver involvement in tularemia, even with treatment.
• Physicians should consider hepatic tularemia in patients with unexplained liver enzyme elevations and tularemia symptoms.
• Early diagnosis and appropriate management are crucial to prevent severe outcomes of hepatic tularemia.