A case of primary tularemic pneumonia presenting with necrotizing mediastinal and hilar lymph nodes

被引:9
作者
Valipour, A [1 ]
Koller, H [1 ]
Kreuzer, A [1 ]
Kössler, W [1 ]
Csokay, A [1 ]
Burghuber, OC [1 ]
机构
[1] Pulmol Zentrum, Interne Lungenabt 1, A-1140 Vienna, Austria
关键词
infection; tularemia; inhalation; pneumonia; lymphadenopathy; bronchoscopy;
D O I
10.1007/BF03040310
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Tularemia is an unusual disease caused by the gram-negative coccobacillus Francisella tularensis. The clinical features of the disease depend on the route of inoculation. Ulceroglandular and typhoidal forms have been recognized as occurring in tularemia, however primary or secondary pneumonic infections have also been reported. Symptoms, laboratory markers and radiological features are non-specific in tularemic pneumonia. Diagnosis is made on clinical grounds and evidence of elevated agglutinating antibodies to F tularensis (> 1: 128). We report a case of primary tularemic pneumonia presenting with pulmonary infiltrates and necrotizing mediastinal and hilar lymph nodes in an otherwise healthy subject from a non-endemic area. Diagnosis of tularemia was obtained serologically, and antibiotic therapy with doxycycline and streptomycin resolved symptoms and radiological abnormalities. We suggest that tularemia should be considered in the differential diagnosis of pneumonia with mediastinal and/or hilar lymphadenopathy.
引用
收藏
页码:196 / 199
页数:4
相关论文
共 29 条
  • [1] AVERY FW, 1967, AM REV RESPIR DIS, V95, P584
  • [2] PLEUROPULMONARY TULAREMIA - ITS ROENTGEN MANIFESTATIONS
    DENNIS, JM
    BOUDREAU, RP
    [J]. RADIOLOGY, 1957, 68 (01) : 25 - 30
  • [3] Tularemia
    Ellis, J
    Oyston, PCF
    Green, M
    Titball, RW
    [J]. CLINICAL MICROBIOLOGY REVIEWS, 2002, 15 (04) : 631 - +
  • [4] An outbreak of primary pneumonic tularemia on martha's vineyard
    Feldman, KA
    Enscore, RE
    Lathrop, SL
    Matyas, BT
    McGuill, M
    Schriefer, ME
    Stiles-Enos, D
    Dennis, DT
    Petersen, LR
    Hayes, EB
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (22) : 1601 - 1606
  • [5] Finley C R, 1986, Mo Med, V83, P741
  • [6] Tularemia - A summary of certain aspects of the disease including methods for early diagnosis and the results of serum treatment in 600 patients
    Foshay, L
    [J]. MEDICINE, 1940, 19 (01) : 1 - 83
  • [7] FRASER RG, 1989, DIAGNOSIS DIS CHEST, P870
  • [8] Tularemia presenting as community-acquired pneumonia - Implications in the era of managed care
    Fredricks, DN
    Remington, JS
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1996, 156 (18) : 2137 - 2140
  • [9] Gill V, 1997, Semin Respir Infect, V12, P61
  • [10] Gurycova D., 1999, Epidemiologie Mikrobiologie Imunologie, V48, P97