{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:19:10Z","timestamp":1790410750882,"version":"4.1.0"},"reference-count":20,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,27]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium <jats:italic>Francisella tularensis<\/jats:italic>.\n<jats:sup>1<\/jats:sup>\n Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Subsequently, the patient fully recovered from the illness and the follow-up was negative for relapse.<\/jats:p>","DOI":"10.1136\/bcr-2019-229754","type":"journal-article","created":{"date-parts":[[2019,9,7]],"date-time":"2019-09-07T07:15:19Z","timestamp":1567840519000},"page":"e229754","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Paediatric oropharyngeal tularaemia requiring surgical intervention"],"prefix":"10.1136","volume":"12","author":[{"given":"Amina","family":"Nemmour","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adzreil","family":"Bakri","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland"},{"name":"Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude A","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Brand","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland"},{"name":"University Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,6]]},"reference":[{"key":"2025082712493359000_12.9.e229754.1","unstructured":"Richard FJ , Gordon ES . Tularemia. In: Dennis LK , Anthony SF , eds. Harrison\u2019s Infectious Diseases. New York: The Mc-Graw-Hill, 2010:552\u20137."},{"key":"2025082712493359000_12.9.e229754.2","unstructured":"European Centre for Disease Prevention and Control. Annual epidemiological report for 2015 \u2013 Tularemia. https:\/\/ecdc.europa.eu\/sites\/portal\/files\/documents\/AER_for_2015-tularaemia.pdf"},{"key":"2025082712493359000_12.9.e229754.3","unstructured":"Swiss Federal Office of Public Health. Overview of Tularemia. https:\/\/www.bag.admin.ch\/bag\/de\/home\/krankheiten\/krankheiten-im-ueberblick\/tularaemie.html"},{"key":"2025082712493359000_12.9.e229754.4","doi-asserted-by":"crossref","unstructured":"Penn RL . Francisella tularensis (Tularemia). In: Bennet JE , Dolin R , Blaser MJ , eds. Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases. 8th ed. 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