Tularämie-Lymphadenitis

Strehl, Johanna; Schoerner, Christoph; Hartmann, Anke; Agaimy, Abbas

doi:10.1007/s00292-013-1851-5

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…The data related to the histopathological features of lymphadenomegaly in tularaemia are restricted to small case series [25,30,31]. Usually, reactive changes without necrosis have been reported in the early stages.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tularaemia courses: a multicentre study from Turkey

Erdem

Öztürk-Engin

Yeşilyurt³

et al. 2014

Clinical Microbiology and Infection

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In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with β-lactam/β-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.

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Section: Discussionmentioning

confidence: 99%

Evaluation of tularaemia courses: a multicentre study from Turkey

Erdem

Öztürk-Engin

Yeşilyurt³

et al. 2014

Clinical Microbiology and Infection

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“…Histopathological characterization of lymphadenomegaly in tularemia is usually limited due to the small number of cases (Leblebicioglu et al, 2008;Ulu-Kilic et al, 2013;Strehl et al, 2014). Reactive changes not detected in necrosis were reported mostly in the initial stages.…”

Section: Discussionmentioning

confidence: 99%

Analyses of tularemia cases and their long-term results

Udurgucu¹

2021

Trop Biomed

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Tularemia is a zoonotic disease and endemic in the northern hemisphere. The gram-negative coccobacillus Francisella tularensis causes this disease (Ellis et al., 2002). It is a facultative intracellular pathogen that mostly proliferates in host macrophages (Pechous et al., 2009). F. tularensis is endemic also in Turkey, and infection occurs via several routes and results in different clinical syndromes (Gotschlich & Berkin, 2007). In general, laboratory workers, farmers and gardeners are at a higher risk of contacting with tularemia. Clinical symptoms vary from asymptomatic disease to septic shock and death, depending on the infecting strain, site of infection, bacterial load, and the host immune status (Penn, 2010). The most common route of the disease transmission is contact with infected animals and ticks, and that in our country is the intake of contaminated natural or non-chlorinated water (Gürcan et al., 2004; Willke et al., 2009). The diagnosis of tularemia is usually given lately because it is seen with lymphadenopathy; it is confused with nonspecific laboratory findings and nonspecific pathological findings; and it is not considered usually in differential diagnosis. The epidemiology of the cases may change over time and the incidence of the clinical forms of the tularemia may change accordingly. In this study, we aimed to evaluate tularemia cases in this respect and compare them with regional and world literature. The aim of this study was to evaluate the epidemiological, clinical and laboratory characteristics of tularemia patients, and reanalyze their physical conditions and lymphadenopathy during the follow-up. MATERIALS AND METHODS Study design, settings and ethics This study has been conducted in accordance with the principles of the Helsinki Declaration and approved by the local Institutional Review Board (date of the approval: 04/05/ 2017, number of the approval: 08/20). Patients who were diagnosed with tularemia in the National reference laboratory and monitored in our clinic between 2011 and 2017 were retrospectively reviewed. All patients who were diagnosed with tularemia were included in the study. Their age, sex, epidemiologic anamnesis, symptoms, physical condition, complete blood count, creactive protein, erythrocyte sedimentation rate, tularemia polymerase chain reaction, Micro-agglutination titration (MAT), imaging, pathology results, treatment regimens and follow-ups were recorded. In addition, all patients were invited for the second time. The patients were contacted by telephone and invited to our outpatient clinic for the long term, physical, laboratory and radiological evaluations. All patients provided signed consents after they agreed to participate in the study. Patients who could not reach out from their recorded phone numbers

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“…The histologic examination of the regional lymph node revealed a necrotizing and granulomatous lymphadenitis [ 5 ]. Granulomatous lymphadenitis may be representative of infectious or noninfectious processes.…”

Section: Discussionmentioning

confidence: 99%

Long-Lasting Fever and Lymphadenitis: Think aboutF. tularensis

Longo

Jaton

Pilo

et al. 2015

Case Reports in Medicine

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We report the case of glandular tularemia that developed in a man supposedly infected by a tick bite in Western Switzerland. Francisella tularensis (F. tularensis) was identified. In Europe tularemia most commonly manifests itself as ulcero-glandular or glandular disease; the diagnosis of tularemia may be delayed in glandular form where skin or mucous lesion is absent, particularly in areas which are assumed to have a low incidence of the disease.

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Tularämie-Lymphadenitis

Cited by 8 publications

References 23 publications

Evaluation of tularaemia courses: a multicentre study from Turkey

Evaluation of tularaemia courses: a multicentre study from Turkey

Analyses of tularemia cases and their long-term results

Long-Lasting Fever and Lymphadenitis: Think aboutF. tularensis

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