Clinical review of tularemia cases, evaluation of treatment approaches: single-center retrospective study.

PURPOSE: Tularemia is a zoonotic disease caused by Francisella tularensis, a gram-negative, facultative coccobacillus. Tularemia may present with symptoms of tonsillopharyngitis, such as sore throat and neck swelling, or with symptoms of conjunctivitis, such as redness in the eyes. The aim is to emphasize the importance of considering tularemia in the differential diagnosis of patients presenting with these complaints.

METHODS

The study was designed as a retrospective descriptive study including 10 patients who were diagnosed with tularemia and treated between November 2023 and August 2025.

RESULTS

The patients were between 19 and 69 years of age, with a mean age of 47.2 ± 18.4 years. Six patients were male and four were female. The most common presenting symptoms were sore throat (n = 7, 70%) and cervical lymphadenopathy/swelling (n = 7, 70%). The oropharyngeal form was observed in six patients, the oculoglandular form in three patients, and a combination form in one patient. All patients were initially started on doxycycline therapy. In addition to medical treatment, abscess drainage was performed in six patients (60%), and these patients were subsequently started on one of second-line treatments: streptomycin, ciprofloxacin, or gentamicin.

CONCLUSION

Tularemia often presents with non-specific, influenza-like symptoms and signs of conjunctivitis may therefore be easily overlooked in clinical practice. Clinicians should be well acquainted with the various clinical forms of tularemia and consistently consider the disease in the differential diagnosis. Successful management of tularemia depends on early recognition, the appropriate antimicrobial agents, and the timely implementation of necessary surgical interventions.