While ulceroglandular and glandular tularemia
remain the more common presentation, a number of outbreaks of typhoidal and pulmonary tularemia have been reported and reflect a diverse range of environmental exposures resulting in infection.
This case report details the clinical manifestation and course of glandular tularemia, an uncommon but significant cause of cervical lymphadenopathy in children.
Moreover, the risk of morbidity and mortality in patients with glandular tularemia is best minimized by specific antimicrobial therapy that is not usually considered for the more common causes of infectious lymphadenopathy.
In this article, we describe a case of glandular tularemia in a child, and we review the physical, laboratory, and radiologic findings of this disease as well as the response to medical and surgical therapy.
One week after surgery, a reference laboratory in Salt Lake City identified F tularensis in the abscess fluid, which established the diagnosis of glandular tularemia.
In conclusion, our case was marked by several distinguishing characteristics, knowledge of which may alert the clinician to consider a diagnosis of glandular tularemia rather than one of the more common pyogenic cervical adenopathies.