title: [Pleuropulmonary tularemia in a 63-year-old hunter in Germany].
abstract: METHODS
  A 63-year-old amateur hunter without relevant preexisting diseases presented with cough lasting for 4 weeks and B symptoms.
  
  
  METHODS
  Radiography and ultrasonography showed a left-sided pleural effusion. Laboratory markers of infection were in normal range. A thoracocentesis was performed for diagnostic purposes.
  
  
  METHODS
  Culture of Francisella tularensis spp. holarctica from pleural fluid led to the diagnosis of tularemia with unusual manifestation as an isolated one-sided pleuritis, confirmed by highly positive serology. The patient fully recovered on oral treatment with doxycycline.
  
  
  CONCLUSIONS
  Due to its low prevalence in Germany and multiple possible clinical manifestations, the diagnosis of tularemia can be difficult. Hence, it is decisive to include tularemia in the differential diagnosis, especially if anamnestic or epidemiological evidence exists.
authors.affiliation: Institut für Medizinische Laboratoriumsdiagnostik (IML) Bochum GmbH, Bochum.
authors.forename: R
authors.initials: R
authors.lastname: Kohlmann
authors.affiliation: Facharztzentrum am EVK Lippstadt, Lippstadt.
authors.forename: P J
authors.initials: PJ
authors.lastname: Wolf
authors.affiliation: Institut für Medizinische Laboratoriumsdiagnostik (IML) Bochum GmbH, Bochum.
authors.forename: S G
authors.initials: SG
authors.lastname: Gatermann
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005604:Francisella tularensis / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D011001:Pleuropneumonia / Q000175:diagnosis* / Q000382:microbiology*; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000382:microbiology*; D014406:Tularemia / Q000175:diagnosis* / Q000382:microbiology*