Clinical Recognition and Management of Tularemia in Missouri: A Retrospective Records Review of 121 Cases

Weber, Ingrid; Turabelidze, George; Patrick, Sarah; Griffith, Kevin S.; Kugeler, Kiersten J.; Mead, Paul S.

doi:10.1093/cid/cis706

Cited by 72 publications

(67 citation statements)

References 21 publications

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“…A similar age distribution was recently reported from Missouri, USA, which indicates that this type of age distribution is not unique to Sweden (30). Age-related differences in disease incidence could mirror differences in behavior; for example, higherrisk outdoor activities such as farming, hunting, and berrypicking may be more common among 40-70-year-olds.…”

Section: Discussionsupporting

confidence: 76%

Epidemiology and Ecology of Tularemia in Sweden.

Desvars

Furberg

Hjertqvist

et al. 2015

International Journal of Epidemiology

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Section: Discussionsupporting

confidence: 76%

Epidemiology and Ecology of Tularemia in Sweden.

Desvars

Furberg

Hjertqvist

et al. 2015

International Journal of Epidemiology

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“…The source of infection was thought to be a tick bite on the scalp. A retrospective review of 121 cases published in 2012 detailed that 25% of infected subjects were anemic and 11% had thrombocytopenia [19]. This fact, along with possible transient bone marrow suppression by the concurrent parainfluenza infection, can explain the initial pancytopenia in our patient.…”

Section: Discussionmentioning

confidence: 71%

Difficulty in the Clinical Diagnosis of Tularemia: Highlighting the Importance of a Physical Exam

Kumar

Mansour

Brunetto

et al. 2018

Case Reports in Pediatrics

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We report an 18-month-old male who presented with fever and nonspecific symptoms. He was evaluated for multiple differential diagnoses including Kawasaki disease and JIA and received treatment for them. After he was readmitted, tularemia was considered based on the physical exam finding of an ulcer on the scalp and enlarged lymph nodes. Tularemia titers were positive, and the patient was given the appropriate antibiotic and was discharged home. Follow-up of the patient showed complete resolution of symptoms. This is a case that demonstrates the importance of physical exam in identifying rare diseases presenting with common signs and symptoms.

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“…According to the type of bacteria and point of entry, the disease is observed in six different clinical forms, namely ulceroglandular, glandular, oculoglandular, oropharyngeal, pneumonic, and typhoidal (septicemic) tularemia. While the most frequent clinical form in North America is ulceroglandular tularemia [5,6], in Europe [7][8][9] and in Turkey, oropharyngeal tularemia makes up the majority of the tularemia cases [3,10,11].…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey

Karakaş

Çoşkun

Artuk

et al. 2014

J Infect Dev Ctries

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Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results. Methodology: Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded. Results: Twelve of the patients included in this study were males. The average age of the patients was 32.1±17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6±6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare institutions previously. However, despite the treatment, cervical lymphadenopathy had developed in these cases. Patients were given streptomycin, doxycycline, and ciprofloxacin monotherapy or in combination. Ten of the cases fully recovered, while five required surgical lymph node drainage. Spontaneous drainage occurred in the single remaining case. Conclusions: Turkey is considered to be an endemic country with regards to tularemia. Prompt diagnosis and proper treatment of the disease is imperative in providing cure. Since it can be potentially confused with tuberculous lymphadenitis, differential diagnosis is vital. Patients presenting with a condition of tonsillopharyngitis in endemic areas must be carefully monitored.

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Clinical Recognition and Management of Tularemia in Missouri: A Retrospective Records Review of 121 Cases

Cited by 72 publications

References 21 publications

Epidemiology and Ecology of Tularemia in Sweden.

Epidemiology and Ecology of Tularemia in Sweden.

Difficulty in the Clinical Diagnosis of Tularemia: Highlighting the Importance of a Physical Exam

Oropharyngeal tularemia cases admitted to a military hospital in Ankara, Turkey

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