title: A case of tularemia presenting as a dental abscess: case report.
abstract: OBJECTIVE
  The purpose of this report is to present a tularemia case accompanied by a neck mass that easily may be confounded with dental abscess.
  
  
  CONCLUSIONS
  Francisella tularensis is a potential agent of biologic terrorism. Thirty percent of the symptoms seen in tularemia localize in the head and neck region and are sometimes mistaken for complications of a dental abscess. To our knowledge, reports of the differential diagnostic characteristics of tularemia are lacking in the dental literature and, to date, no dental journal articles have focused on the disease. In this present case, a 51-year-old woman arrived at the public health department with high fever and facial swelling. The findings suggested a dental origin and the patient was directed to dentistry. Radiology and a detailed intraoral and extraoral examination failed to reveal a dental problem. Fortunately, the patient was known to come from a tularemia region; with the suspicion of tularemia the patient was referred to the faculty of medicine. Serologic tests showed that the patient had a Francisella tularensis infection.
authors.affiliation: Ondokuz Mayis University, Faculty of Dentistry, Department of Endodontics, Kurupelit-Samsun, Turkey. utunga@omu.edu.tr
authors.forename: Umut
authors.initials: U
authors.lastname: Tunga
authors.forename: Emre
authors.initials: E
authors.lastname: Bodrumlu
authors.forename: Aydan
authors.initials: A
authors.lastname: Acikgoz
authors.forename: Gokhan
authors.initials: G
authors.lastname: Acikgoz
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000382:microbiology; D005604:Francisella tularensis / Q000302:isolation & purification*; D006801:Humans; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D010482:Periapical Abscess / Q000175:diagnosis; D013363:Submandibular Gland / Q000382:microbiology; D013364:Submandibular Gland Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014406:Tularemia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology