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Abstract

Tularemia is a zoonotic disease caused by the coccobacillus F. tularensis. Small epidemics and sporadic cases were seen around Bursa since November 1988. In this study, a total of 205 cases of tularemia were observed. All the cases were diagnosed on clinical, bacteriological and serological grounds. The epidemics were thought to be waterborne. The majority of the patients were young and female. In most of the cases the disease presented itself in oropharyngeal form (83%). Analysing sera from the patients with microagglutination method demonstrated that titers were > or = 1:160 in approximately 85% of the cases, including the ones in subclinical form. Five of ten patients from who the bacteria was isolated were seronegative. Streptomycin was given to the most of the patients by combining with tetracycline, doxycycline or chloramphenicol. The early administration of these antibiotics (before the third week of disease) was found to be much more effective to resolve the infection. As a result, the main mode of transmission of F. tularensis is waterborne in our region. In our region, tularemia should be considered in differential diagnosis for the cases with fever, tonsillopharyngitis and cervical lymphadenopathy to make an early diagnosis and to design relevant treatment.

A Suppurative Granulomatous Lymphadenitis Agent: Tularemia, Case Report

“…The infection may also cause hepatitis, meningitis, pericarditis, sepsis and septic shock (3) . Enlarged lymph nodes, cervical and periauricular region being more frequently involved, are seen in nearly 85% of the cases.…”

“…Other than streptomycin, gentamicin, tetracycline, chloramphenicol and more recently quinolones are also recommended (3) . In our case ciprofloxacin retreatment were given after Tularemia diagnosis and his complaints were regressed.…”

“…Tularemia is a disease caused by a Gram-negative coccobacillus Francisella tularensis (1)(2)(3) . It is transmitted to humans by arthropod and animal bites, contact with infected animal products, consumption of infected water or meat, aerosol droplets, or in the laboratory (2) .…”

Tularemia

“…Contaminated wells that serve as public water supply have been a source for numerous human cases of tularemia in Europe. 53,55,72 Contamination generally results from infected animals contaminating water that feeds the well, or by those animals entering the well itself. War, civil strife, and other conditions that may negatively impact the quality of public water supplies in tularemia endemic areas can contribute to the occurrence of this disease.…”

“…11 For example, the water supply is considered to be the most important source of F. tularensis in Turkey, with infected rodents being the source of contamination. 55 A leading North American investigator has theorized that the evolution and spread of tularemia organisms has occurred with Rodentia, in contrast to the viewpoint of an equally prominent Russian investigator who theorizes that the evolution of Francisella was mainly within Lagomorpha and less within Rodentia. 102 In either case, the long association of Francisella with these two major groups of animals has afforded eons of time for adaptive host-parasite relations to be formed.…”