Nefise ÖZTOPRAK, GÜVEN ÇELEBİ, Atilla ALPAY, Ayşegül Seremet KESKİN, Yasemin KOZLUCA

Oculoglandular and oropharyngeal tularemia: A case report and review of the literature

Tularemi hastalığı küçük, Gram-negatif, pleomorfik kokobasil olan Francisella tularensis bakterisi ile oluşur. Okuloglanduler tularemi nadir görülen bir formdur. Okologlanduler tularemi ile ilgili az sayıda yayın vardır, PubMed taramasında günümüze kadar 20'den az yayın bulunmaktadır. Bu yazıda okuloglanduler ve orofaringeal tularemi tanısı konulan, 31 yaşında bir bayan olgu sunuldu ve okuloglanduler tularemi ile ilgili yayınlar derlendi. Olgu hastanemize üç haftadır devam eden ani başlangıçlı ateş, halsizlik, baş ağrısı, boğaz ağrısı, sol gözde kızarıklık, üst göz kapağında şişlik, göz yaşında artma ve sol preaurikuler bölgede ağrısız şişlik ve genel vücut ağrısı ile başvurdu, göz travması öyküsü yoktu. Tulareminin endemik olduğu bir köyde oturuyordu, hayvan teması öyküsü yoktu. Klinik bulgularla okuloglanduler ve orofaringeal tularemi tanısı konuldu, tanı mikroaglütinasyon testi ve PCR ile konfirme edildi. Olgu siprofloksasin tedavisinin sekizinci gününde tamamen iyileşti. Tularemi, ateş, boğaz ağrısı, konjunktivit ve servikal kitlesi olan ve özellikle penisilin veya sefalosporin tedavisine yanıt vermeyen ve tulareminin endemik olduğu bölgeden gelen olgularda akla gelmelidir.

Anahtar Kelimeler:

Polimeraz zincir reaksiyonu, Orofarinks, Tularemi, Erişkin, Kadın

Okuloglanduler ve orofaringeal tularemi: Olgu sunumu ve literatür derlemesi

Tularemia is caused by a small, Gram-negative, pleomorphic coccobacillus, Francisella tularensis. Oculoglandular tularemia is a rare clinical form. There are few reports about oculoglandular tularemia, and less than 20 cases with oculaglandular tularemia have been reported in PubMed up to date. We reviewed the literature about oculoglandular tularemia, and reported a 31-year-old woman with oculoglandular and oropharyngeal tularemia. She admitted to our hospital with a three-week history of sudden onset of fever, fatigue, headache, sore throat, swollen left upper lid, injected and erythematous left eye, epiphora, preauricular nontender lump on the left and generalized aches, but there was no history of eye injury. She was living in a village where tularemia is endemic, but no history of encountering with an animal. The clinical diagnosis of oculoglandular and orophayngeal tularemia was confirmed by microagglutination test and PCR. She was fully improved on the eighth day of the ciprofloxacine treatment. Tularemia should come to mind in patients with fever, severe throat, conjunctivitis and cervical masses especially unresponsive to penicillin or cephalosporine therapy, coming from a tularemia endemic area.

Keywords:

Polymerase Chain Reaction, Oropharynx, Tularemia, Adult, Female,

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