First Tularemia Outbreak in the Province of Muş: Evaluation of 50 Cases

Benli, Aysun

doi:10.36519/kd.2022.3623

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…In periods when the number of tularemia cases was high (it reached its peak level in 2011), the duration of diagnosis was shortened due to the large number of studies carried out by the Ministry of Health to increase awareness. However, there are delays in diagnosis, especially in regions where tularemia is not endemic, patients have to use unnecessary antibiotics due to misdiagnosis [ 7 , 11 , 14 , 15 ]. In our study, patients used beta-lactam group antibiotics most frequently before the diagnosis of tularemia.…”

Section: Discussionmentioning

confidence: 99%

Tularemia in the Differential Diagnosis of Lymphadenitis: A Retrospective Analysis of 16 Cases

Binay¹,

Barkay²,

Karakeçili³

2023

Cureus

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Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis , a gram-negative, facultative, intracellular coccobacillus. It can occur in different clinical forms, and the most common form in our country (Turkey) is the oropharyngeal form. Unfortunately, the diagnosis of lymphadenitis caused by tularemia is delayed unless it is suspected, especially in sporadic cases. Our aim is to remind clinicians to have tularemia among differentials of lymphadenitis. Methods: In this study, the clinical and laboratory findings of 16 tularemia patients between 2011 and 2021 were evaluated retrospectively. Results: The mean age of the 16 patients included in the study was 39 years, and 62.5% were female. The patients were diagnosed with tularemia on the average 31st day of their complaints. The rate of use of beta-lactam group antibiotics before diagnosis was 74%. About 81.25% of the patients were engaged in animal husbandry/farming, and living in rural areas (93.75%) and farming (81.25%) were the most common possible risk factors. The patients were admitted to the hospital with the most common complaints of enlarged lymph nodes (100%), fatigue (62.5%) and loss of appetite (56.25%). All patients had lymphadenopathy, and the most common location of lymphadenopathy was the cervical region (81.25%). Moxifloxacin (56.25%) was used most frequently in the treatment of tularemia, and surgical drainage was performed for 31% of the patients. Conclusion: The diagnosis of tularemia is often delayed unless clinical suspicion is high. Delayed diagnosis may lead to unnecessary frequent use of antibiotics, especially beta-lactam group antibiotics. As the diagnosis is delayed, since lymph node suppuration is common, surgical intervention may be required. This situation can cause extra burden for both patients and the health system. It may be beneficial to organize trainings to increase awareness among physicians and society in order to make the diagnosis early.

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Section: Discussionmentioning

confidence: 99%

Tularemia in the Differential Diagnosis of Lymphadenitis: A Retrospective Analysis of 16 Cases

Binay¹,

Barkay²,

Karakeçili³

2023

Cureus

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Water-borne oculoglandular tularemia: Two complicated cases and a review of the literature

Copur

Sürme²

2023

Travel Medicine and Infectious Disease

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Seroprevalence of Francisella tularensis in patients with neck mass complaints

Toprak¹,

Ayral²,

Dedeoğlu³

et al. 2023

Northwestern Med J

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Aim: Tularemia is a zoonotic disease endemic in the northern hemisphere. The causative agent of the disease is Francisella tularensis. F.tularensis is endemic in Turkey, predominantly in the Marmara and Black Sea regions, and causes small outbreaks. This study aimed to investigate the seroprevalence of F.tularensis in patients admitted to the Otorhinolaryngology outpatient clinic with the complaint of neck mass by using two different methods.Methods: Serum samples were collected from patients who were admitted to the Otorhinolaryngology outpatient clinic of Dicle University Faculty of Medicine Hospitals between January 2021 and December 2021 with the complaint of neck mass. A commercially available immunochromatographic lateral flow test (ICT) and a single-assay chemiluminescence test (CHT) were used to detect F.tularensis antibodies. Rose-Bengal test was performed on all sera to determine cross-reactions with antibodies produced in brucellosis. Brucella immunocapture agglutination tests (BCT) were performed on the sera of patients with positive screening tests.Results: The ages of patients diagnosed with neck mass ranged between 14–70 years, with a mean age of 44.5±12.1 years. Sixty two (62%) of the patients were male, and 38 (38%) were female. When the test results were evaluated, two sera were positive for F.tularensis by both ICT and CHT methods. The first serum tests were negative for Brucella. The titer of the second serum in the chemiluminescence test was low positive.Conclusion: Tularemia should be considered in the differential diagnosis of patients presenting with neck mass complaints, especially in patients living in rural areas, and specific diagnostic tests should be performed. In addition, a more comprehensive seroprevalence study supported by molecular testing techniques to be conducted in Diyarbakır will provide clearer data on the extent to which tularemia affects our region and which subspecies is the causative agent.

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First Tularemia Outbreak in the Province of Muş: Evaluation of 50 Cases

Cited by 3 publications

References 9 publications

Tularemia in the Differential Diagnosis of Lymphadenitis: A Retrospective Analysis of 16 Cases

Tularemia in the Differential Diagnosis of Lymphadenitis: A Retrospective Analysis of 16 Cases

Water-borne oculoglandular tularemia: Two complicated cases and a review of the literature

Seroprevalence of Francisella tularensis in patients with neck mass complaints

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