{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:53:51Z","timestamp":1782168831946,"version":"3.54.5"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Tular\u00e4mie ist eine seltene Zoonose, verursacht durch Francisella tularensis, deren pulmonale Manifestation in Mitteleuropa nur sporadisch auftritt und diagnostisch besonders herausfordernd sein kann.<\/jats:p>\n                  <jats:p>Wir berichten \u00fcber einen 58-j\u00e4hrigen Patienten mit B-symptomatik bei welchem computertomografisch eine thorakale Raumforderung detektiert wurde.<\/jats:p>\n                  <jats:p>Die weiterf\u00fchrende bildgebende Diagnostik zeigte eine metabolisch aktive mediastinale Raumforderung mit Lymphadenopathie, verd\u00e4chtig auf ein Bronchialkarzinom. Erst die chirurgische Mediastinoskopie mit Nachweis granulomat\u00f6s-histiozyt\u00e4rer Entz\u00fcndungen sowie die weiterf\u00fchrende infektiologische Diagnostik f\u00fchrten zur Diagnose einer pulmonalen Tular\u00e4mie.<\/jats:p>\n                  <jats:p>Unter einer 20-t\u00e4gigen Therapie mit Doxycyclin kam es zu einer raschen klinischen Besserung und vollst\u00e4ndigen laborchemischen sowie radiologischen Regression der Lymphadenopathie.<\/jats:p>\n                  <jats:p>Der Fall unterstreicht, dass die pulmonale Tular\u00e4mie malignen Prozessen morphologisch und metabolisch \u00e4hneln kann. Eine fr\u00fchzeitige Einbeziehung infektiologischer Differenzialdiagnosen sowie die Kombination aus Histologie, Serologie und molekularbiologischen Verfahren sind entscheidend, um Fehldiagnosen und unn\u00f6tige invasive Ma\u00dfnahmen zu vermeiden.<\/jats:p>","DOI":"10.1055\/a-2843-5923","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:38:00Z","timestamp":1782167880000},"page":"692-696","source":"Crossref","is-referenced-by-count":0,"title":["\u201eNicht alles, was nach Tumor aussieht...\u201c \u2013 Pulmonale Tular\u00e4mie mit hil\u00e4rer Lymphadenopathie"],"prefix":"10.1055","volume":"151","author":[{"given":"Jonas","family":"Fr\u00fch","sequence":"additional","affiliation":[{"name":"Klinikum W\u00fcrzburg Mitte gGmbH, Standort Missioklinik, Deutschland","place":["W\u00fcrzburg"],"department":["Medizinische Klinik mit Schwerpunkt Pneumologie & Beatmungsmedizin"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Zange","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Mikrobiologie der Bundeswehr, Deutschland","place":["M\u00fcnchen"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Polyklinik II, Uniklinikum W\u00fcrzburg, Deutschland","place":["W\u00fcrzburg"],"department":["Schwerpunkt Infektiologie, Tropen- und Reisemedizin"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.3390\/microorganisms8091448","article-title":"Francisella tularensis Subspecies holarctica and Tularemia in Germany","volume":"8","author":"S 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