Evaluation of case series of delayed tularaemia

Tularemia is a zoonotic disease caused by the gram-negative bacterium Francisella tularensis. Clinical suspicion is extremely important and serology is the gold standard for diagnosis. The oropharyngeal form of tularemia in Turkey takes the form of outbreaks or sporadic cases. Delay in diagnosis is the major factor in complications. Five delayed cases of tularemia in the Marmara region of Turkey are described in this paper between 2009-2015 years. All patients’ diagnoses were confirmed with serology, and all had LAP on their neck regions. The lymphadenopathies persisted despite medical treatment four being excised by Ear Nose and Throat Clinic (ENT). Tularemia must be considered in the evaluation of masses on the neck, particularly in endemic areas. The most important factor in the successful management of tularemia is early initiation of treatment. The risk of suppuration and surgical interventions increases in delayed cases

Neuroborreliosis

Lyme hastalığı, Borrelia burgdorferi’nin etken olduğu, artropod aracılı bir hastalık olup, multisistemik tutulum gösteren klinik bulguları ile tüberküloz, bruselloz, sifiliz gibi ‘büyük taklitçi’ enfeksiyon hastalıkları arasındadır. Hastalık esnasında görülen çok sayıda nörolojik belirtinin varlığı "nöroborrelyoz" adlı antitenin ortaya çıkmasına neden olmuştur. Spirokete karşı immünolojik yanıt ve etkenin direkt hasarı hastalığın klinik bulgularını da belirlemektedir. Etken menenjit, kraniyal nörit, fasiyal paralizi, kronik ensefalomiyelit, spastik paraparezi ve hatta mental değişiklikler ile seyreden pekçok farklı nörolojik tablodan sorumlu tutulabilir. Erken tanı ve tedavi, hastalığın ilerlemesinin yanı sıra, bakterinin persiste etmesini de önler. Vektör olan kene türlerinin ülkemizde de bulunması nedeni ile nöroborrelyoz ayırıcı tanımızda yer almalıdır.Lyme disease, that’s causative agent Borrelia burgdorferi, is an arthropod-borne disease. This disease is among the “great imitator” infec- tious diseases like tuberculosis, brucellosis and syphilis, due to it’s multisystem clinical involvement. The presence of multiple neurological signs during the disease has led the entity named as “neuroborreliosis”. The immunological response against the spirochete and direct dam- age of the agent determines the clinical manifestations of the disease. The agent may be responsible for many different neurological diagno- sis as meningitis, cranial neuritis, facial paralysis, chronic encephalomiyelitis, spastic paraparesis, and even mental changes. Early diagnosis and treatment prevents the persistence of the bacteria as well as the progression of the disease. Because of the presence of the tick vector species in our country, the neuroborreliosis should be included in our differential diagnosis