• K Chevalier, M-D Venon, J-F Émile, D Cabral, S Siméon, M Trichet, É Rouveix, T Hanslik, and L Coutte.
• Service de médecine interne, hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France. Electronic address: kevinchevalier05@gmail.com.
• Rev Med Interne. 2020 Sep 1; 41 (9): 632-636.

IntroductionAdenopathies are a frequent cause of recourse in internal medicine. When histological analysis reveals the presence of granuloma, multiple infectious or non-infectious etiologies are considered. If diagnoses of lymphoma, sarcoidosis or tuberculosis are easily mentioned, tularemia should also be considered in the differential diagnosis.ObservationA 54-year-old patient had a fever at the evening with night sweats and a cough resistant to two lines of antibiotics. A thoraco-abdomino-pelvic CT scan revealed hilar and mediastinal adenopathies that appeared hypermetabolic with PET-TDM, as well as pulmonary nodules. A PCR performed on lymph node biopsy and serology allowed the diagnosis of tularemia. The evolution was favourable after antibiotic treatment.ConclusionThe association of fever, night sweats, altered general state and mediastinal adenopathies should be considered as a diagnosis of tularemia. Ganglionic biopsy, combined with molecular biology techniques and serology, can confirm the diagnosis.Copyright © 2020. Published by Elsevier Masson SAS.

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