Case Report of Systemic Tularemia in Cyprus

Abstract

Tularemia is a zoonotic infectious disease in the Northern Hemisphere, which is caused by gram-negative Francisella tularensis bacteria with four subtypes. In this article, a case of a 5-year-old girl with oculoglandular, oropharyngeal, and typhoid tularemia accompanied by lymph nodes in the abdomen has been presented. Amoxicillin-clavulanic acid treatment was first applied to the patient who had high fever, neck lymphadenopathy, and crypts in the tonsils.Intramuscular ceftriaxone therapy was started after the expected response could not be obtained. As a result, as there was no improvement in response to both the treatments in the clinical condition of the patient, and the patient was hospitalized. Physical examination revealed the presence of cervical and submandibular lymphadenopathy and left otitis media. Hepatosplenomegaly and bilateral periorbital edema developed on the day after admission to the hospital. The most frequent diseases in the age group of the patient that may cause the observed findings were tried to be excluded by laboratory and radiological data.Upon learning that the patient had contact with the suspected infected rabbit during treatment, Francisella tularensis antibody was ordered for differential diagnosis of tularemia. The test result was reported as 1:80 titre positive. The patient's treatment was changed to a combination of ciprofloxacin plus amikacin. A gradual improvement was observed, and a follow-up evaluation two weeks later revealed that the patient had recovered with no complication. This case is the first proven case feature and is worthy of showing the importance of getting detailed anamnesis.

Investigation of Francisella tularensis Seroprevalence and Determination of Risk Factors for Tularemia among Hunters in Northern Cyprus

“…Moreover, there is one case (a 5-year-old girl) of tularemia reported in the http://jad.tums.ac.ir Published Online: March 31, 2024 literature so far, and it has been reported that this case was in contact with an infected wild rabbit. In the patient's anamnesis, there was a history of contact with wild rabbits hunted by his father who was a hunter (8). Our study is the first to carry out research that showed tularemia seroprevalence in our country among hunters who are considered to be risk groups and showed a high seroprevalence (17%).…”

“…Tularemia is an infection that can be seen all over the world, although its prevalence is higher, especially in the northern hemisphere (between 30-71° latitudes) (3)(4)(5). Tularemia cases have recently been reported in Europe (6), Turkey (7), Iran (4), Jordan (1) and also Cyprus (8). The dis-48 http://jad.tums.ac.ir Published Online: March 31, 2024 ease is referred to by different names in various geographical regions such as Francis' Disease, Pahvant Valley plaque, hunters' disease, rabbit fever, deer fly fever, and tick fever (9,10).…”

A Rare Complication of Oropharyngeal Tularemia: Pneumonia Treated with Levofloxacin

“…Little is known about tularemia in Northern Cyprus. A single case was reported in 2017 by Uncu et al [9] .…”