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2018 ; 61
(2
): 49-52
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Treatment-failure tularemia in children
#MMPMID29563944
Karl? A
; ?ensoy G
; Paksu ?
; Korkmaz MF
; Ertu?rul Ö
; Karl? R
Korean J Pediatr
2018[Feb]; 61
(2
): 49-52
PMID29563944
show ga
PURPOSE: Tularemia is an infection caused by Francisella tularensis. Its
diagnosis and treatment may be difficult in many cases. The aim of this study was
to evaluate treatment modalities for pediatric tularemia patients who do not
respond to medical treatment. METHODS: A single-center, retrospective study was
performed. A total of 19 children with oropharyngeal tularemia were included.
RESULTS: Before diagnosis, the duration of symptoms in patients was 32.15±17.8
days. The most common lymph node localization was the cervical chain. All
patients received medical treatment (e.g., streptomycin, gentamicin,
ciprofloxacin, and doxycycline). Patients who had been given streptomycin,
gentamicin, or doxycycline as initial therapy for 10-14 days showed no response
to treatment, and recovery was only achieved after administration of oral
ciprofloxacin. Response to treatment was delayed in 5 patients who had been given
ciprofloxacin as initial therapy. Surgical incision and drainage were performed
in 9 patients (47.5%) who were unresponsive to medical treatment and were
experiencing abcess formation and suppuration. Five patients (26.3%) underwent
total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to
reach a conclusive differential diagnosis and inform treatment. CONCLUSION: The
causes of treatment failure in tularemia include delay in effective treatment and
the development of suppurating lymph nodes.
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