Granulomatous pleuritis caused by Francisella tularensis: possible confusion with tuberculous pleuritis.
Granulomatous pleuritis, diagnosed by pleural biopsy, is rarely caused by disease processes other than tuberculosis. We present a case of granulomatous pleuritis caused by Francisella tularensis that occurred in a 55-yr-old male sheep shearer with an exudative, lymphocytic, pleural effusion. Confirmation of the diagnosis was made by elevated serum agglutination titers against F. tularensis and detection of the organism in a pleural biopsy specimen by the glucose oxidase immunoenzyme technique. We conclude that F. tularensis, not previously described as a cause of granulomatous pleuritis, must be considered in the differential diagnosis of granulomas found in pleural biopsy specimens.
D001706:Biopsy; D003937:Diagnosis, Differential; D005604:Francisella tularensis; D006099:Granuloma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology; D010994:Pleura / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology; D010998:Pleurisy / Q000175:diagnosis / Q000209:etiology*; D014396:Tuberculosis, Pleural / Q000175:diagnosis*; D014406:Tularemia / Q000175:diagnosis*