Tre ovanliga fall av tularemi i Värmland. Misstänkt smitta via vatten, infekterat damm och insekter
Sammanfattning
During recent years there has been a significant increase in the number of cases of tularemia in the county of Värmland in Sweden. Our general practitioners have become quite skilled in diagnosing this disease due to the fact that they encounter it so often. However, not all of these cases present themselves with the typical symptomatology. The authors describe two cases with unusual symtoms and one case with fatal outcome in a patient with severe manifestations of arteriosclerotic disease. The first case also outlines the possibility of tularemia transmission by drinking contaminated water from a private well. This case also illustrates the well known fact that the formation of an abscess continues despite adequate antibiotic therapy if there is a delay in its initiation.