The glandular form of tularaemia is a rare cause of nodular syndrome in childhood. Recently the disease is encountered increasingly in adults but also in children. In recent years we treated at the Clinic a single patient in 1995, in autumn 1998 there were already four patients within 3 months. Unilateral lymphadenitis was in three instances cervical, twice axillary. In all patients the enlarged nodes were extirpated but the histological examination did not reveal an unequivocal diagnosis. Only evidence of a raised agglutinin titre against tularaemia was decisive. Concurrent antibiotic treatment led in all children to cure. Contraction of the infection by injury or a tick was found only in three instances, in two children penetration of the infection through intact skin is assumed. The nodular form of tularaemia must be taken into account in the differential diagnosis in addition to tuberculosis, avian mycobacteriosis and other uncommon conditions. Even less common in tularaemia is affection of the lungs. It was observed during the same period in three boys aged 12 - 16 years. The pulmonary finding is characterized by tumourous hilar adenopathy and thus it is important to rule out in particular tuberculosis or a tumour. The course is protracted, lasting several weeks to months, and doxycycline and azithromycin proved the best therapy. The diagnosis is confirmed by serological evidence of agglutinins. In the acute stage their titre may attain high levels. The disease is usually contracted by inhalation.

        Key words: tularaemia, nodular syndrome, pulmonary affection, hilar adenopathy, paediatrics