title: Tularaemia after tick exposure - typical presentation of rare disease misdiagnosed as atypical presentation of common diseases: a case report.
abstract: A 44-year-old female was admitted because of tender, enlarged inguinal lymph nodes with a history of tick bite five weeks earlier. In the place of a tick bite on the skin a small ulcer was present. The primary symptoms before admission suggested typical diseases related to tick bite such as Lyme borreliosis and tick-borne encephalitis, what corresponded with positive IgM ELISA test for Lyme borreliosis. The course of disease however clarified the diagnosis of tularaemia, which is a relatively rare disease in Poland (6 cases per 40 million population are reported annually). The ultimate diagnosis was confirmed by serological tests.
authors.affiliation: Department of Zoonotic and Tropical Diseases, Medical University of Warsaw ul. Wolska 37, 01-201 Warsaw Poland. karolinaswitaj@yahoo.co.uk
authors.forename: Karolina
authors.initials: K
authors.lastname: Switaj
authors.forename: Maria
authors.initials: M
authors.lastname: Olszynska-Krowicka
authors.forename: Hanna
authors.initials: H
authors.lastname: Zarnowska-Prymek
authors.forename: Piotr
authors.initials: P
authors.lastname: Zaborowski