KBB-Forum 2015 , Cilt 14, Sayı 1

MANAGEMENT OF CERVICAL LYMPHADENOPATHY IN PATIENTS WITH TULAREMIA

Emel TAHİR, MD; Nilda SÜSLÜ, MD; Serdar ÖZER, MD; M. Demir BAJİN, MD
Hacettepe University, School of Medicine, Ankara, Turkey Purpose: To report the efficacy of lymph node drainage and oral ciprofloxacin treatment in tularemia patients with suppurative cervical lymphadenitis.

Materials and Methods: The study included 14 patients with cervical lymphadenitis or abscess caused by tularemia. All the patients were diagnosed by the help of the microagglutination test. All of the patients were treated using oral antibiotics, and drainage of the suppurative lymph node. Oral quinolones were used instead of parenteal streptomycin or gentamycin which have more side effects such as ototoxicty. All of the patients in the present study were followed-up on an outpatient basis.

Results: 10 out of 14 patients were healed following oral ciprofloxacin or doxycycline treatment, and proper lymph node drainage. Prompt drainage of abscess reduced the need of intravenous antibiotic usage and surgical excision of the lymph node.

In all, 4 of the patients underwent surgical removal of infected lymph nodes that resistant to medical treatment and drainage.

Conclusion: Careful out-patient follow up with regular drainage and proper antibiotic therapy reduces hospitalization need and invasive surgical intervention rate. Keywords : Tularemia, cervical lymphadenitis, ciprofloxacin, surgery, puncture