Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report

Abstract Background Cervical lymph node swelling is quite a common symptom mainly caused by infections in the face or as metastasis of a malignant tumor. In infection cases in particular, rare diseases should never be overlooked. With an incidence of 120 cases in the United States of America (USA) a...

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Main Authors: R. Rothweiler, M. A. Fuessinger, R. Schmelzeisen, M. C. Metzger
Format: Article
Language:English
Published: BMC 2019-08-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13256-019-2165-x
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author R. Rothweiler
M. A. Fuessinger
R. Schmelzeisen
M. C. Metzger
author_facet R. Rothweiler
M. A. Fuessinger
R. Schmelzeisen
M. C. Metzger
author_sort R. Rothweiler
collection DOAJ
description Abstract Background Cervical lymph node swelling is quite a common symptom mainly caused by infections in the face or as metastasis of a malignant tumor. In infection cases in particular, rare diseases should never be overlooked. With an incidence of 120 cases in the United States of America (USA) and approximately 25 cases in Germany per year, infection with the pathogen Francisella tularensis is one of these rare diseases that can cause massive lymph node swellings and might even be fatal. Case presentation The example of a healthy 67-year-old German woman who was treated at our university hospital presents a typical progression of a localized form of tularemia. The pathogen could be identified in a universal 16S ribosomal deoxyribonucleic acid (DNA) polymerase chain reaction. Pathogen-specific treatment with lymph node abscess incision, daily rinsing of the abscess cavity, and orally administered antibiotic therapy with doxycycline could cure our patient completely without any remaining complications. Conclusion In patients with cervical lymph node swelling caused by infection it is indispensable to perform specific identification of the pathogen for further local and specific antibiotic treatment. Possible infections with atypical bacteria like Francisella tularensis should never be ignored. Universal polymerase chain reactions are a suitable method for early detection of such rare pathogens.
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spelling doaj.art-f23f6134748243cb9fde9d8d359314ff2022-12-22T00:16:40ZengBMCJournal of Medical Case Reports1752-19472019-08-011311610.1186/s13256-019-2165-xLymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case reportR. Rothweiler0M. A. Fuessinger1R. Schmelzeisen2M. C. Metzger3Department of Oral and Maxillofacial Surgery Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery Faculty of Medicine, University of FreiburgAbstract Background Cervical lymph node swelling is quite a common symptom mainly caused by infections in the face or as metastasis of a malignant tumor. In infection cases in particular, rare diseases should never be overlooked. With an incidence of 120 cases in the United States of America (USA) and approximately 25 cases in Germany per year, infection with the pathogen Francisella tularensis is one of these rare diseases that can cause massive lymph node swellings and might even be fatal. Case presentation The example of a healthy 67-year-old German woman who was treated at our university hospital presents a typical progression of a localized form of tularemia. The pathogen could be identified in a universal 16S ribosomal deoxyribonucleic acid (DNA) polymerase chain reaction. Pathogen-specific treatment with lymph node abscess incision, daily rinsing of the abscess cavity, and orally administered antibiotic therapy with doxycycline could cure our patient completely without any remaining complications. Conclusion In patients with cervical lymph node swelling caused by infection it is indispensable to perform specific identification of the pathogen for further local and specific antibiotic treatment. Possible infections with atypical bacteria like Francisella tularensis should never be ignored. Universal polymerase chain reactions are a suitable method for early detection of such rare pathogens.http://link.springer.com/article/10.1186/s13256-019-2165-xFrancisella tularensisUnilateral lymph nodeAbscessInfection
spellingShingle R. Rothweiler
M. A. Fuessinger
R. Schmelzeisen
M. C. Metzger
Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
Journal of Medical Case Reports
Francisella tularensis
Unilateral lymph node
Abscess
Infection
title Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
title_full Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
title_fullStr Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
title_full_unstemmed Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
title_short Lymph node abscess caused by Francisella tularensis – a rare differential diagnosis for cervical lymph node swelling: a case report
title_sort lymph node abscess caused by francisella tularensis a rare differential diagnosis for cervical lymph node swelling a case report
topic Francisella tularensis
Unilateral lymph node
Abscess
Infection
url http://link.springer.com/article/10.1186/s13256-019-2165-x
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AT rschmelzeisen lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport
AT mcmetzger lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport