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Cases J. 2009 Jul 31;2:7954. doi: 10.4076/1757-1626-2-7954.

Tularaemia after tick exposure - typical presentation of rare disease misdiagnosed as atypical presentation of common diseases: a case report.

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  • 1Department of Zoonotic and Tropical Diseases, Medical University of Warsaw ul. Wolska 37, 01-201 Warsaw Poland.


A 44-year-old female was admitted because of tender, enlarged inguinal lymph nodes with a history of tick bite five weeks earlier. In the place of a tick bite on the skin a small ulcer was present. The primary symptoms before admission suggested typical diseases related to tick bite such as Lyme borreliosis and tick-borne encephalitis, what corresponded with positive IgM ELISA test for Lyme borreliosis. The course of disease however clarified the diagnosis of tularaemia, which is a relatively rare disease in Poland (6 cases per 40 million population are reported annually). The ultimate diagnosis was confirmed by serological tests.

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