Tularemia is an acute infection transmitted by handling flesh of infected animals, by the bite of insect vectors, by inoculation of conjunctiva, by ingestion of infected food, or by inhalation; it manifests as four patterns: ulceroglandular, oculoglandular, typhoidal, pulmonary.
Causes of Tularemia
After inoculation, F.tularensis reproduces and spreads through lymphatic channels to lymph nodes and bloodstream.
Symptoms of Tularemia
- red spot on the skin, enlarging to an ulcer
- enlarged lymph nodes of groin or armpits
- headache
- muscle pains
- possible conjunctivitis
- shortness of breath
- fever
- chills
- sweating
- weight loss
- joint stiffness
Diagnosis
Clinical diagnosis in a patient with chancriform syndrome with appropriate animal exposure or insect exposure and systemic manifestations. Disease in pneumonic presentation has “flulike” symptomatology and is fatal if unrecognized.
Treatment
Drug of Choice Streptomycin, 1 to 2 g/d for 7 to 10 afebrile days, is most effective at cure and prevention of relapse.
Alternatives Gentamycin, tetracycline, chloramphenicol effect lower cure rate and higher relapse rates.
Prevention
Avoid contact with wild rabbits. In tick-infested areas, wear tight wristbands and pants tucked into boots to prevent tick attachment. Inspect for ticks at day’s end. Vaccine in development. Wear rubber gloves when handling or processing wild rabbits.
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