title: Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey.
abstract: BACKGROUND
  This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results.
  
  
  METHODS
  Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded.
  
  
  RESULTS
  Twelve of the patients included in this study were males. The average age of the patients was 32.1 ± 17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6 ± 6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare institutions previously. However, despite the treatment, cervical lymphadenopathy had developed in these cases. Patients were given streptomycin, doxycycline, and ciprofloxacin monotherapy or in combination. Ten of the cases fully recovered, while five required surgical lymph node drainage. Spontaneous drainage occurred in the single remaining case.
  
  
  CONCLUSIONS
  Turkey is considered to be an endemic country with regards to tularemia. Prompt diagnosis and proper treatment of the disease is imperative in providing cure. Since it can be potentially confused with tuberculous lymphadenitis, differential diagnosis is vital. Patients presenting with a condition of tonsillopharyngitis in endemic areas must be carefully monitored.
authors.affiliation: Gulhane Military Medical Academy, Etlik, Ankara, Turkey. akarakas@gata.edu.tr.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakas
authors.forename: Omer
authors.initials: O
authors.lastname: Coskun
authors.forename: Cumhur
authors.initials: C
authors.lastname: Artuk
authors.forename: Umit
authors.initials: U
authors.lastname: Savasci
authors.forename: Hanefi Cem
authors.initials: HC
authors.lastname: Gul
authors.forename: Gurkan
authors.initials: G
authors.lastname: Mert
authors.forename: Ismail Yasar
authors.initials: IY
authors.lastname: Avci
authors.forename: Bulent Ahmet
authors.initials: BA
authors.lastname: Besirbellioglu
authors.forename: Can Polat
authors.initials: CP
authors.lastname: Eyigun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014406:Tularemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents