title: Ultrasonography and contrast-enhanced CT findings of tularemia in the neck.
abstract: OBJECTIVE
  We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck.
  
  
  METHODS
  US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients.
  
  
  RESULTS
  Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC.
  
  
  CONCLUSIONS
  Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas.
authors: Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey. drserapdogan@hotmail.com.
authors: Serap
authors: S
authors: Doğan
authors: Afra
authors: A
authors: Ekinci
authors: Hayati
authors: H
authors: Demiraslan
authors: Ayşegül
authors: A
authors: Ulu Kılıç
authors: Ertuğrul
authors: E
authors: Mavili
authors: Mustafa
authors: M
authors: Öztürk
authors: Hakan
authors: H
authors: İmamoğlu
authors: Mehmet
authors: M
authors: Doğanay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014406:Tularemia / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media