{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:03:54Z","timestamp":1790726634768,"version":"4.1.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Ein 63-j\u00e4hriger Patient stellte sich mit 5-t\u00e4gigem Fieber, Nachtschwei\u00df und produktivem Husten vor. Anamnestisch hatte der Patient Renovierungsarbeiten auf einem Dachboden durchgef\u00fchrt, wobei Kontakt zu toten Flederm\u00e4usen bestand. Unter Amoxicillin\/Clavulans\u00e4ure trat keine Besserung ein.<\/jats:p>\n                  <jats:p>Die CT des Thorax zeigte eine L\u00e4sion im rechten Oberlappen mit mediastinaler Lymphknoten-Beteiligung, hochgradig verd\u00e4chtig auf ein Lungenkarzinom. Bronchoskopie, EBUS-TBNA und thorakoskopische Biopsie ergaben eine Entz\u00fcndung ohne Malignit\u00e4tsnachweis. Die PCR des gewonnenen Gewebes war positiv f\u00fcr Francisella tularensis, best\u00e4tigt durch die Serologie. Die Diagnose einer pulmonalen Tular\u00e4mie wurde gestellt.<\/jats:p>\n                  <jats:p>Die Behandlung erfolgte mit Gentamicin und Doxycyclin f\u00fcr 7 bzw. 14 Tage. Nach Beginn der antibiotischen Therapie war der Patient beschwerdefrei.<\/jats:p>\n                  <jats:p>Da heutzutage CTs weit verbreitet sind und die Befunde der pulmonalen Tular\u00e4mie einem malignen Prozess \u00e4hneln, muss sie als Differenzialdiagnose von Lungenkarzinomen beachtet werden. Eine detaillierte Anamnese, inklusive der Expositionsrisiken, ist unabdingbar, um unn\u00f6tige invasive Abkl\u00e4rungsschritte zu vermeiden.<\/jats:p>","DOI":"10.1055\/a-2896-8801","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T22:53:41Z","timestamp":1786402421000},"page":"887-891","source":"Crossref","is-referenced-by-count":0,"title":["Vorsicht vor Flederm\u00e4usen: Wie sich eine seltene Infektion als Lungentumor maskieren kann \u2013 ein Fallbericht"],"prefix":"10.1055","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2547-0991","authenticated-orcid":false,"given":"Lisa","family":"Larcher","sequence":"additional","affiliation":[{"name":"Stadtspital Z\u00fcrich Triemli: Stadtspital Zurich Triemli, SWITZERLAND","place":["Z\u00fcrich"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Graup","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsspital Z\u00fcrich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Wagnetz","sequence":"additional","affiliation":[{"name":"Stadtspital Triemli"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Scholtze","sequence":"additional","affiliation":[{"name":"Stadtspital Triemli"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"00093","DOI":"10.1183\/23120541.00093-2019","article-title":"Pulmonary tularaemia: A differential diagnosis to lung cancer","volume":"6","author":"A Kravdal","year":"2020","journal-title":"ERJ Open Res"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12890-015-0026-y","article-title":"Pulmonary tularaemia: All that looks like cancer is not necessarily cancer \u2013 Case report of four consecutive cases","volume":"15","author":"P Fachinger","year":"2015","journal-title":"BMC Pulm Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.ejim.2025.03.013","article-title":"Tularemia for clinicians: An up-to-date review on epidemiology, diagnosis, prevention and treatment","volume":"135","author":"RM Antonello","year":"2025","journal-title":"Eur J Intern Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1056\/NEJMcp2303286","article-title":"Community-Acquired Pneumonia","volume":"389","author":"TM File","year":"2023","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1378\/chest.12-2352","article-title":"Clinical and Organizational Factors in the Initial Evaluation of Patients With Lung Cancer","volume":"143","author":"DE Ost","year":"2013","journal-title":"Chest"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1056\/NEJMra1200894","article-title":"Tuberculosis","volume":"368","author":"A Zumla","year":"2013","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1017\/S0950268814002398","article-title":"The status of tularemia in Europe in a one-health context: a review","volume":"143","author":"G Hestvik","year":"2015","journal-title":"Epidemiol Infect"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1080\/23744235.2017.1341054","article-title":"Pneumonic tularaemia: experience of 58 cases from 2000 to 2012 in Northern Finland","volume":"49","author":"SA V\u00e4yrynen","year":"2017","journal-title":"Infect Dis (Lond)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1017\/s0022215100100775","article-title":"Bronchial changes in airborne tularemia","volume":"100","author":"H Syrj\u00e4l\u00e4","year":"1986","journal-title":"J Laryngol Otol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"277","DOI":"10.2214\/ajr.131.2.277","article-title":"Radiographic Spectrum of Pleuropulmonary Tularemia","volume":"131","author":"SA Rubin","year":"1978","journal-title":"AJR Am J Roentgenol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1080\/0284186X.2017.1315172","article-title":"Lung cancer guidelines in Sweden, Denmark, Norway and Finland: a comparison","volume":"56","author":"NL Christensen","year":"2017","journal-title":"Acta Oncol"}],"container-title":["DMW - 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