Pulmonary tularemia: a clinical case report
General Medicine, 2025, 27(1), 21-25.
K. Ketev1,3, I. Karavelikova1,2, D. Milanova-Ilieva1, B. Angelov4
1 Department of Pediatrics, University Hospital Sv. Georgi ‒ Plovdiv
2 Department of Pediatrics, Medical University ‒ Plovdiv
3 Medical Simulation Training Center, Medical University ‒ Plovdiv
4 Department of Pediatrics, UMHAT ‒ Burgas
Abstract. Tularemia is an infectious disease belonging to the group of zoonoses, presenting with diverse clinical forms depending on the affected organ system. In Bulgaria, it was first described by Rangachev in 1952, and 34 cases have been registered in the last decade. The authors present a case of a 17-yearold child with the pulmonary form of tularemia. The patient presented with chronic cough, fever, asthenoadynamia, and lymphadenomegaly. After serological confirmation of the disease and initiation of etiological treatment, the patient‘s condition significantly improved. This case highlights the importance of thorough clinical evaluation and the use of specific tests for diagnosing rare infectious diseases like tularemia. Diagnosing tularemia presents a challenge for pediatricians. In children with prolonged and treatmentresistant pneumonia, timely referral to a specialized pulmonology department is crucial. Failure to recognize this rare disease in our geographic region may result in a fatal outcome.
Key words: tularemia, pneumonia, Francisella tularensis, zoonosis
Address for correspondence: Kostadin Ketev, e-mail: kostadin.ketev@mu-plovdiv.bg