Tularemia - Diagnosis and Management Summary

Francisella tularensis - Aerobic fastidious gram-negative Coccobacillus - Zoonotic Infection

 • Ulceroglandular: Fever + erythematous papulo-ulcerative lesion; Tender lymphadenopathy; +/- suppuration

 • Glandular: Regional lymphadenopathy single or multiple nodes (suppurative); Most common presentation among children; No evident lesion at the site of inoculation

 • Oculoglandular: Splashing infected material into eye; unilateral symptoms (pain, photophobia, increased tearing); Parinaud's Oculoglandular Sx

 • Pharyngeal: Ingestion of contaminated food/water; small percentage in the United States

 • Pneumonic: Direct inoculation of the organism into the lungs; More common in adults - farmers, sheep shearers, landscapers

 • Typhoidal: Systemic febrile illness without prominent regional adenopathy; Affected patients often have chronic underlying conditions

Diagnosis: Serology (preferred), Culture & GS, PCR

Treatment: 

 • Severe Disease: Gentamicin, Streptomycin

 • Moderate Disease: 1) Ciprofloxacin / Levofloxacin 2) Doxycycline



By @TheIDtrivia



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