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

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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.

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

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