Tularemia in Adults and Children: A Changing Presentation

Abstract

Tularemia, a febrile zoonosis with six clinical types, recently has been shown to occur at an increased incidence in children compared with previous reports. Ulceroglandular and glandular tularemia are still the most common types, but pneumonic tularemia has increased in incidence. However, with these changes, an overall decline in mortality has been observed. Children exhibit fever, pharyngitis, hepatosplenomegaly, and constitutional symptoms more often than affected adults. The complication of late lymph node suppuration is found in half of the tularemia patients with lymphadenopathy. A high index of clinical suspicion and a good medical history and physical examination confirmed by specific serologic studies are the critical factors in the successful diagnosis of tularemia in children.

Francisella and tularemia in western Asia, Iran: a systematic review

“…F. tularensis subsp. holarctica has been isolated in North America, Japan, Asia, and Europe, and is associated with waterborne infection in rodents, and different vectors [ 29 , [33] , [34] , [35] , [36] , [37] , [38] ]. Although F. tularensis cause lymphadenopathy, pinpoint white spots on the liver and spleen, chronic nephritis, bacteriuria, and necrotic manifestations among rodents, they are known as a putative reservoir or vector for the transmission cycle of this bacterium.…”

Tularemia Presenting Solely with Cervical Lymphadenopathy and Fever

“…Glandular tularemia displays without characteristic skin lesions and is found more often in children than in adults [ 10 ].…”