# 18F-FDG PET/CT Findings in Glandular Tularemia

## TL;DR

A woman with glandular tularemia showed high metabolic activity on a PET/CT scan, highlighting the challenges in diagnosing this disease.

## Contribution

This case illustrates the role of 18F-FDG PET/CT in diagnosing glandular tularemia when other methods are inconclusive.

## Key findings

- PET/CT showed high metabolic activity in the left inguinal region, suggesting abscesses.
- Diagnosis was confirmed with PCR and serology for Francisella tularensis.
- The case emphasizes the difficulty in diagnosing tularemia and the value of imaging.

## Abstract

A 47-year-old woman presented with fever, fatigue, night sweats and inguinal glandular swelling following a tick bite. Weeks of diagnostic uncertainty followed, and a lymph node biopsy was sent to be investigated for tularemia and pathology. An 18F-FDG PET/CT scan was performed due to a suspicion of malignant lymphoma. The scan revealed high metabolic activity in the left inguinal region, which was compatible with abscesses. The diagnosis of glandular tularemia was established on a positive PCR for Francisella tularensis (F. tularensis) and positive F. tularensis serology. This case highlights the challenges of diagnosing tularemia and illustrates the role of imaging.