title: Tularemia is becoming increasingly important as a differential diagnosis in suspicious neck masses: experience in Turkey.
abstract: Neck mass can be an initial finding of many diseases at any age. The differential diagnosis is broad and includes inflammatory, congenital and neoplastic lesions. We retrospectively analyzed charts of the 145 patients with neck mass and without known primary malignancy whose diagnoses were confirmed with histopathologic and serologic examination between July 2003 and July 2008. Twenty-six patients (17.9%) were diagnosed with tularemia. Before 2004, serologic testing for tularemia was not a part of our workup for patients with an inflammatory neck mass. Otolaryngologists should be familiar with head and neck manifestations of tularemia and consider the disease in the differential diagnosis of neck masses. The tularemia outbreak in central Black Sea region, Turkey in 2004 changed our approach to a patient presenting with neck mass.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayis University School of Medicine, Tip Fak. KBB Anabilim Dali, Kurupelit, 55139, Samsun, Turkey. sinanatmaca@yahoo.com
authors.forename: Sinan
authors.initials: S
authors.lastname: Atmaca
authors.forename: Cem
authors.initials: C
authors.lastname: Bayraktar
authors.forename: Senem
authors.initials: S
authors.lastname: Cengel
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koyuncu
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D001706:Biopsy; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D004724:Endoscopy; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009333:Neck; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D014406:Tularemia / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014421:Turkey; D055815:Young Adult