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Vol. 60. Issue 1.
Pages 54-58 (January 2009)
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Vol. 60. Issue 1.
Pages 54-58 (January 2009)
Treatment of cervical adenopathies secondary to oropharyngeal tularaemia. Our experience in 8 patients
Tratamiento de adenopatías cervicales secundarias a tularemia orofaríngea. Nuestra experiencia en 8 pacientes
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José Escapa-Garrachóna, José Ignacio Martín-Serradillab,
Corresponding author
jserradilla@ono.com

Corresponding author.
, Ignacio Alonso Castañeiraa, Jorge Freijanes Oteroa, Paula de las Heras Flóreza, José Luis Alonso Treceñoa
a Servicio de Otorrinolaringología, Complejo Hospitalario de Palencia, Palencia, Spain
b Servicio de Medicina Interna, Complejo Hospitalario de Palencia, Palencia, Spain
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Abstract

Tularaemia is an uncommon zoonosis in our country. During the outbreak in 2007, there was a notably high incidence of the oropharyngeal form. We report our experience in 8 patients with oropharyngeal tularaemia with cervical adenopathies.

The mean age was 45 years (11–76), with 5 males. All suffered oropharyngeal pain, fever, and asthenia. The time elapsed between the onset of symptoms and attending our clinic varied from 8 to 60 days. Mean duration of oropharyngeal symptoms was 11.7 days, and adenopathies appeared in the first 3 days. Resolution of adenopathies occurred at 2 to 3.5 months. Three cases needed surgical drainage and 2 fistulized spontaneously. Seven patients were treated with ciprofloxacin and 1 with erythromycin.

A correct and precocious antibiotic therapy, and sometimes surgical drainage, could accelerate the healing process.

Keywords:
Tularaemia
Cervical adenopathy
Ciprofloxacin
Surgical drainage
Fistula
Resumen

La tularemia es una zoonosis infrecuente en España. En el brote iniciado en 2007, destaca la elevada incidencia de su forma orofaríngea. Describimos nuestra experiencia en el tratamiento de 8 pacientes con adenopatías cervicales por tularemia orofaríngea.

El estudio se realizó en 5 varones y 3 mujeres, con una edad media de 45,3 (rango: 11–76) años. En todos aparecieron dolor orofaríngeo, fiebre y astenia. El tiempo desde el comienzo de los síntomas hasta la consulta a nuestro servicio osciló entre 8 y 60 días. La duración media de los síntomas orofaríngeos fue de 11,7 días, y las adenopatías aparecieron en los primeros 3 días. La resolución de estas adenopatías ocurrió al cabo de 2–3,5 meses. Tres casos precisaron el drenaje quirúrgico y 2, fistulizaron de forma espontánea. Se trató a 7 pacientes con ciprofloxacino y a uno con eritromicina.

Un correcto tratamiento antibiótico temprano, y en algunos casos el drenaje quirúrgico, podrían acelerar la curación.

Palabras clave:
Tularemia
Adenopatía cervical
Ciprofloxacino
Drenaje quirúrgico
Fístula

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