Fellows’ Corner

Laura Marks, MD, PhD

Laura Marks, MD, PhD
Laura Marks, MD, PhD

Laura Marks, MD, PhD, second year fellow, had a featured case in the New England Journal of Medicine of Glandular Tularemia.A 68-year-old man from Missouri presented to the primary care clinic with a history of 1 week of fever followed by 2 months of progressive, painful swelling on the right side of his neck.Two days prior, his cat died. Serologic testing with IgM antibody was positive for Francisella tularensis (titer, 1:1280). A diagnosis of glandular tularemia was made. Glandular tularemia is the second most common manifestation of tularemia after the ulceroglandular form. Because culture requires biosafety level 3 conditions, diagnosis is often confirmed serologically. Domestic cats can become infected through the consumption of infected prey and can transmit the bacteria to humans. The patient was treated with doxycycline for 4 weeks; the lesions improved within 5 days and resolved within 3 weeks.