Two Tularemia Cases with Atypical Presentation

Tularemia is a zoonosis caused by Francisella tularensis, a Gram-negative coccobacillus. Oropharyngeal tularemia is due to bacteria penetrating the oral mucosa during intake of contaminated water and food and is the common form seen in our country. Oculoglandular tularemia is rarely reported. In this report, two oropharyngeal tularemia cases from the same province, Cankiri, are presented. The first was associated with an oculoglandular form and the second with a diffuse skin rash. Tularemia cases have rarely been reported from this province. Cases in unexpected forms lead to difficulties in the differential diagnosis of patients. Therefore clinicians should be aware of aypical presentations, apart from the classic case descriptions, and also recognise the cutaneous lesions of tularemia and consider tularemia in patients with eruptions having an epidemiological history.