Pediatric Tularemia—A Case Series From a Single Center in Switzerland

Schöbi, Nina; Agyeman, Philipp; Duppenthaler, Andrea; Bartenstein, Andreas; Keller, Peter M.; Suter‐Riniker, Franziska; Schmidt, Kristina Maria; Kopp, Matthias; Aebi, Christoph

doi:10.1093/ofid/ofac292

Cited by 6 publications

(1 citation statement)

References 48 publications

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“…Rates of incision and drainage appear to be lower in our cohort than in studies from France (27%) and the United States (19%) [ 13 , 39 ], perhaps potentially related to shorter time until institution of appropriate antibiotic treatment. Even higher rates (60%) have been reported in pediatric populations [ 40 ]. The clinical value of prolonged antibiotic treatment in drained suppurative lymphadenitis remains unclear and will require further studies, potentially stratified by PCR status and/or culture.…”

Section: Discussionmentioning

confidence: 99%

Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden

Plymoth,

Lundqvist,

Nystedt

et al. 2024

Clinical Infectious Diseases

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Background Tularemia is an important re-emerging disease with a multimodal transmission-pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden. Methods Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011-2021 were collected through review of electronic medical records and participant questionnaires; with 415 out of 784 accepting participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or PCR). A multivariable logistic regression model was used to investigate variables associated with re-treatment. Results Median age of participants was 54 years (IQR 41.5-65) and 49.2% were female. While ulceroglandular tularemia was the predominant form (n=215, 65.7%), there were several cases of pulmonary tularemia (n=40; 12.2%). Inflammatory markers were largely non-specific, with monocytosis frequently observed (n=36/75; 48%). Tularemia was often misdiagnosed upon presentation (n=158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics, and 102 (31.2%) re-treated. Persistent lymphadenopathy was infrequent (n=22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with re-treatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR 3.25-20.75] vs. 7 [IQR 4-11.25] days; adjusted p=0.076), and doxycycline-based treatment regimen (vs. ciprofloxacin; adjusted p=0.084), although not significant after correction for multiple comparisons. Conclusion We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis and timely commencement of treatment for an appropriate duration.

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Section: Discussionmentioning

confidence: 99%

Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden

Plymoth,

Lundqvist,

Nystedt

et al. 2024

Clinical Infectious Diseases

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Unusual pediatric lung infections: imaging findings

Plut,

Winant,

Mahomed

et al. 2023

Pediatr Radiol

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Pediatric lung infections continue to be a leading cause of pediatric morbidity and mortality. Although both pediatric and general radiologists are familiar with typical lung infections and their imaging findings in children, relatively rare lung infections continue to present a diagnostic challenge. In addition, the advances in radiological imaging and emergence of several new lung infections in recent years facilitated the need for up-to-date knowledge on this topic. In this review article, we discuss the imaging findings of pediatric lung infections caused by unusual/uncommon and new pathogens. We review the epidemiological, clinical, and radiological imaging findings of viral (coronavirus disease 2019, Middle East respiratory syndrome, bird flu), bacterial (Streptococcus anginosus, Francisella tularensis, Chlamydia psittaci), and parasitic lung infections (echinococcosis, paragonimiasis, amoebiasis). Additional disorders whose clinical course and imaging findings may mimic lung infections in children (hypersensitivity pneumonitis, pulmonary hemorrhage, eosinophilic pneumonia) are also presented, to aid in differential diagnosis. As the clinical presentation of children with new and unusual lung infections is often non-specific, imaging evaluation plays an important role in initial detection, follow-up for disease progression, and assessment of potential complications. Graphical Abstract

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Ulceroglandular Tularemia from the Bite of a Deerfly in Utah

Wormser¹,

Wormser²

2023

The American Journal of Medicine

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Pediatric Tularemia—A Case Series From a Single Center in Switzerland

Cited by 6 publications

References 48 publications

Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden

Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden

Unusual pediatric lung infections: imaging findings

Ulceroglandular Tularemia from the Bite of a Deerfly in Utah

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