Factors Affecting Cervical Lymph Node Suppuration in Oropharyngeal Tularemia Cases.

ABSTRACT

OBJECTIVE:  To determine the factors associated with cervical lymph node suppuration in oropharyngeal tularemia. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY  Departments of Infectious Diseases and Clinical Microbiology, Faculties of Medicine, Duzce University and Bolu Abant Izzet Baysal University Turkey, between January 2016 and August 2019. METHODOLOGY: Tularemia was diagnosed in clinically compatible cases by micro-agglutination test (≥1/160 titres). Positive cases were divided into two groups according to development of suppurated and discharging lymph nodes. If the cases did not develop suppuration and discharge lymph nodes, they were defined as completely healed. If they did, they were defined as "suppurated and drained lymph node group." Demographic and clinical characteristics and acute phase reactants of these groups were compared as to investigate any significant difference between the groups. RESULTS: There were 88 tularemia cases in the current study. Of these, 60 cases were completely healed (68.2%) and 28 cases had suppurated and drained lymph nodes (31.8%). Tonsillopharyngitis was found significantly lower in suppurated and drained lymph node group compared to the completely healed group (p= 0.016). However, late presentation (>14 days) was found significantly more frequent in suppurated and drained lymph node group compared to the completely healed group (p=0.033). CONCLUSION: In order to prevent suppurative lymphadenitis in oropharyngeal tularemia, it is advisable to start appropriate antimicrobials within 14 days after the appearance of symptoms. Key Words Oropharyngeal tularemia, Cervical lymph node suppuration, Antibiotic initiation time.