ABSTRACT

Tularemia is a zoonotic diseases which is reported 500,000 new case every year in globally and over 500 number case comes from Turkey. Responsible agent is a Francisella tularensis which is coccobacillus shaped and gram negative bacteria. Clinical features can be changeable and depends on host immun response, inoculation dosage, entrance and virulence of bacteria. Tularemia can be emergent in various manifestation like as a subclinic mild situation or severe sepsis. Globally most observed form in human is ulceroglandular tularemia which mostly can be seen in North America, Asia and Europe. In our country oropharyngeal tularemia is most detected form and case reports has been send nearly form all regions notably Black sea and Marmara. Making diagnose is late because tularemia can be miscible with a lot of diseases especially other infections and because of delay of medical treatment, lymph node suppuration would be progressed. In despite of rare mentioned disease about differential diagnose of head and neck mass, it must come to minds especially with the case cervical lymphadenitis and erythema nodosum. Risky groups are people live in rural areas, farmers, hunters, butchers, cooks, nature lovers. Diagnostic titers are considered to be >1:160 in tube agglutination and >1:128 in microagglutination. First option in the treatment is aminoglycosides and it must be provided for at least 10 days. In this article, we try to evaluate tularemia with clinical approach of the case who admit to the clinic presenting with polyarthralgia, erythema nodosum and lymphadenopathy in the Uşak city from Aegean region in Turkey.