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...
Main Authors: | , , , |
---|---|
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 |
_version_ | 1818258391023222784 |
---|---|
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. |
first_indexed | 2024-12-12T17:58:48Z |
format | Article |
id | doaj.art-f23f6134748243cb9fde9d8d359314ff |
institution | Directory Open Access Journal |
issn | 1752-1947 |
language | English |
last_indexed | 2024-12-12T17:58:48Z |
publishDate | 2019-08-01 |
publisher | BMC |
record_format | Article |
series | Journal of Medical Case Reports |
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 |
work_keys_str_mv | AT rrothweiler lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport AT mafuessinger lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport AT rschmelzeisen lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport AT mcmetzger lymphnodeabscesscausedbyfrancisellatularensisararedifferentialdiagnosisforcervicallymphnodeswellingacasereport |