{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:17:34Z","timestamp":1787732254736,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Tularemia is a rare zoonosis caused by the bacterium Francisella tularensis. In the head and neck region, it can manifest as cervical lymphadenopathy. Despite intensive therapy with various antibiotics, there is often a prolonged medical course. Methods: In this paper, all documented cases of tularemia in the head and neck region at the Medical University of Innsbruck (Austria) are analyzed and the results compared with the literature. A retrospective analysis of all patients diagnosed with tularemia at the Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck (Austria), was performed. Tularemia was diagnosed using a serologic agglutination antibody test. Results: Thirteen patients with tularemia presented at the Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck (Austria), between 2010 and 2024. In 10 patients (10\/13; 77%), animal contact or an insect bite was the suspected cause. The mean time from the onset of the first symptoms to diagnosis was 36 \u00b1 15 days. The therapy took a mean of 5 \u00b1 2 months until the last follow-up. On average, the patients were treated with 4 \u00b1 1 different antibiotics. The median duration of hospital stay was 13 days (range: 0\u201336). In addition, a median of 9 (range: 2\u201320) further outpatient check-ups with several neck ultrasounds were carried out. Also, 10 patients (10\/13; 77%) received a diagnostic and\/or therapeutic surgical intervention. Conclusions: Tularemia is a rare infectious disease with a prolonged diagnostic and therapeutic course. Screening for tularemia should be performed in cases of cervical lymphadenopathy, especially if empirical antibiotic treatment has been ineffective or if there is a specific medical history.<\/jats:p>","DOI":"10.3390\/diagnostics15091138","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T11:00:54Z","timestamp":1745924454000},"page":"1138","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Head and Neck Manifestations of Tularemia in Tyrol (Austria): A Case Series"],"prefix":"10.3390","volume":"15","author":[{"given":"Roland","family":"Hartl","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1413-7396","authenticated-orcid":false,"given":"Matthias","family":"Santer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-5825","authenticated-orcid":false,"given":"Wegene","family":"Borena","sequence":"additional","affiliation":[{"name":"Institute of Virology, Department of Hygiene, Microbiology, Social Medicine, Medical University of Innsbruck, Peter-Mayr-Str. 4B, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Schmit","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes Thomas","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Dejaco","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-2877","authenticated-orcid":false,"given":"Benedikt Gabriel","family":"Hofauer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Bernadette","family":"Steinbichler","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"ref_1","first-page":"589","article-title":"Plague among Ground Squirrels in America","volume":"10","author":"McCoy","year":"1910","journal-title":"J. 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