Video:Tularemia

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Description

Tularemia, also known as rabbit fever,[1] is a bacterial infection in humans and some animals.[2] Symptoms may include fever, skin ulcers, and enlarged lymph nodes.[3] Occasionally, a form that results in pneumonia or a throat infection may occur.[3]Prevention is done by using insect repellent, wearing long pants, rapidly removing ticks, and not disturbing dead animals.[4] Treatment is typically with the antibiotic streptomycin.[5] Gentamicin, doxycycline, or ciprofloxacin may also be used.[6]

Presentation 1

Depending on the site of infection, as tularemia has six characteristic variants, each variant presents with different symptoms and requires specific medical attention; hence Ulceroglandular disease presents with cutaneous ulcerations and lymphadenopathy.[7] [8][9]

Presentation 2

Glandular disease that presents with marked lymphadenopathy.[9]

Presentation 3

Respiratory disease that manifests as pneumonia or pleuritis.[9]

Presentation 4

We find that G.I. disease manifests with vomiting, abdominal discomfort, and diarrhea.[9]

Presentation 5

Typhoid tularemia presents as a febrile illness without any early symptoms.[9]

Complications

As to complications we find the affected individual may have the following: ARDS, renal failure, meningitis, lung abscess and peritonitis.[9]

Cause

Tularemia is caused by the bacteria Francisella tularensis which is a pathogenic species of Gram-negative coccobacillus, an aerobic bacterium.[2]

Transmission

The most common way the disease is spread is via arthropod vectors. Ticks involved include Amblyomma, Dermacentor, Haemaphysalis, and Ixodes.[10] Rodents, rabbits, and hares often serve as reservoir hosts,[11] however waterborne infection accounts for 5 to 10 percent of all tularemia in the United States.[12] Tularemia can also be transmitted by biting flies, particularly the deer fly Chrysops discalis. Individual flies can remain infectious for 14 days and ticks for over two years. [13][14]

Diagnosis

In terms of evaluation we find that F. tularensis can be cultured (blood, spinal fluid, lymphatic tissue) to give a diagnosis.[9]In lymph node biopsies, the typical histopathologic pattern is characterized by geographic areas of necrosis with neutrophils and necrotizing granulomas. The pattern is non specific and similar to other infectious lymphadenopathies.[15]

Differential diagnosis

The differential diagnosis of Tularemia in an infected individual is as follows: endocarditis( bacterial or fungal), Chlamydial infections, Lyme disease, Malaria and Q-fever.[9]

Treatment

In terms of treatment for an individual presenting with Tularemia we find that if infection occurs or is suspected, treatment is generally with the antibiotic gentamicin.[16] [17]

Prognosis

Since the invention of antibiotics, the rate of death associated with tularemia has decreased from 60 percent to less than 4 percent.[16]

Epidemiology

Tularemia is most common in the Northern Hemisphere, including North America and parts of Europe and Asia.[16] It occurs between 30 (degrees) and 71 (degrees) north latitude.[16]

History

The tularemia bacterium was first isolated by G.W. McCoy of the United States Public Health Service plague lab and reported in 1912.[18][19]Scientists determined tularemia could be dangerous to humans; a human being may catch the infection after contacting an infected animal. The ailment soon became associated with hunters, cooks and agricultural workers.[20]

References

  1. "Tularemia (Concept Id: C0041351) - MedGen - NCBI". www.ncbi.nlm.nih.gov. Retrieved 22 November 2024.
  2. 2.0 2.1 "Tularemia". CDC.gov. Centers for Disease Control and Prevention. 15 May 2024. Archived from the original on 23 August 2024. Retrieved 22 August 2024.
  3. 3.0 3.1 "Signs and Symptoms Tularemia". CDC. October 2015. Archived from the original on 8 November 2017. Retrieved 8 November 2017.
  4. "Prevention Tularemia". www.cdc.gov. October 2015. Archived from the original on 9 December 2017. Retrieved 8 November 2017.
  5. "Clinicians | Tularemia | CDC". web.archive.org. 8 November 2017. Retrieved 29 November 2024.
  6. "Diagnosis and Treatment | Tularemia | CDC". web.archive.org. 8 November 2017. Retrieved 29 November 2024.
  7. Nemade, Sanjana Vijay; Shinde, Kiran Jaywant (2021). "Tularemia". Granulomatous diseases in Otorhinolaryngology, Head and Neck. Springer. pp. 95–100. doi:10.1007/978-981-16-4047-6_11. ISBN 978-981-16-4047-6.
  8. Plourde PJ, Embree J, Friesen F, Lindsay G, Williams T; Embree; Friesen; Lindsay; Williams (June 1992). "Glandular tularemia with typhoidal features in a Manitoba child". CMAJ. 146 (11): 1953–5. PMC 1490377. PMID 1596844.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 Snowden, Jessica; Simonsen, Kari A. (2024). "Tularemia". StatPearls. StatPearls Publishing.
  10. George W. Beran; James H. Steele (22 October 1994). Handbook of Zoonoses: Bacterial, rickettsial, chlamydial, and mycotic. CRC Press. pp. 117–. ISBN 978-0-8493-3205-0. Retrieved 28 October 2010.
  11. Mörner T (December 1992). "The ecology of tularaemia". Rev. Sci. Tech. 11 (4): 1123–30. doi:10.20506/rst.11.4.657. PMID 1305858.
  12. Jellison WL, Owen C, Bell JF, Kohls GM (1961). "Tularemia and animal populations". Wildl Dis. 17: 1–22.
  13. "Tularemia Transmission". Centers for Disease Control and Prevention. October 26, 2015. Archived from the original on 2017-12-09. Retrieved 2017-10-06.
  14. "How Tularemia Spreads". Tularemia. 17 May 2024. Archived from the original on 2 November 2024. Retrieved 23 November 2024.
  15. Rosado FG, Stratton CW, Mosse CA Clinicopathologic correlation of epidemiologic and histopathologic features of pediatric bacterial lymphadenitis. Arch Pathol Lab Med. 2011 Nov;135(11):1490-3. http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2010-0581-OA
  16. 16.0 16.1 16.2 16.3 Penn, R.L. (2014). Francisella tularensis (Tularemia) In J. E. Bennett, R. Dolin, & M. J. Blaser (Eds.), Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (8th ed.). Philadelphia, PA: Churchill Livingstone. pp. 2590–2602. ISBN 978-1-4557-4801-3.
  17. Hepburn, MJ; Simpson, AJ (April 2008). "Tularemia: current diagnosis and treatment options" (PDF). Expert Review of Anti-infective Therapy. 6 (2): 231–40. doi:10.1586/14787210.6.2.231. PMID 18380605. S2CID 9036831. Archived from the original (PDF) on 2013-12-19. Retrieved 2013-06-30.
  18. Tärnvik, A.; Berglund, L. (February 2003). "A. Tärnvik1 and L. Berglund, Tularaemia. Eur Respir J 2003; 21:361-373". European Respiratory Journal. 21 (2): 361–373. doi:10.1183/09031936.03.00088903. PMID 12608453. Archived from the original on 2010-03-26. Retrieved 2009-11-27.
  19. McCoy GW, Chapin CW. Bacterium tularense, the cause of a plaguelike disease of rodents. Public Health Bull 1912;53:17–23.
  20. "Archived copy". Archived from the original on 2007-06-13. Retrieved 2007-06-04.{{cite web}}: CS1 maint: archived copy as title (link)