Tularemia in Central Anatolia

Ulu-Kılıç, Ayşegül; Gülen, Gönül; Sezen, Figen; Kılıç, Selçuk; Şencan, İrfan

doi:10.1007/s15010-012-0355-1

Cited by 44 publications

(61 citation statements)

References 22 publications

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“…After the period when outbreaks were reported all over the country in 2009, cases (more than 500) were mostly reported from the central Anatolia region, especially from Yozgat (49). If it was considered that the disease in some patients was misdiagnosed and not included in the statistics, the number of the cases would be much higher in Turkey.…”

Section: Reported Tularemia Cases and Frequencymentioning

confidence: 99%

Epidemiology of Tularemia

Gürcan¹

2014

Balkan Med J

104

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Section: Reported Tularemia Cases and Frequencymentioning

confidence: 99%

Epidemiology of Tularemia

Gürcan¹

2014

Balkan Med J

104

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“…Hassas bölgesel lenfadenopati, lezyonla eşzamanlı olarak oluşabileceği gibi öncesi ve sonrasında da görülebil-mektedir. Hayvan temasıyla lezyon daha çok el ve kollarda olurken, vektör kene temasıyla baş, boyun, gövde ve bacaklarda olmaktadır (8,9).…”

Section: İrdelemeunclassified

“…Ancak bakterinin yüksek bulaşıcılığı nedeniyle kültürün biyogüvenlik düzeyi 2 veya 3 olan laboratuvar koşullarında yapılması gerekmektedir (8,9). Tanıda en sık kullanılan yöntem, klinik örneklerden F. tularensis izolasyonu ve/veya MAT'da tek serum örneğinde yüksek titrede antikor varlığı (≥1/160) veya en az 10 gün arayla tekrarlanan serolojik incelemede antikor titresinde dört kat ve üzerinde artış olmasıdır.…”

Section: İrdelemeunclassified

“…Tanıda en sık kullanılan yöntem, klinik örneklerden F. tularensis izolasyonu ve/veya MAT'da tek serum örneğinde yüksek titrede antikor varlığı (≥1/160) veya en az 10 gün arayla tekrarlanan serolojik incelemede antikor titresinde dört kat ve üzerinde artış olmasıdır. Antikor titreleri infeksiyon sonrası iki haftaya kadar güvenilir bir şekilde pozitif sonuç vermeyebilir; bu nedenle akut infeksiyonda tanı değeri düşüktür (9,16). Bizim olgumuzda tularemi tanısı MAT pozitifliğiyle konulmuştur.…”

Section: İrdelemeunclassified

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Delayed Diagnosis of Ulceroglandular Tularemia: A Case Report

Aktepe¹,

Sönmezer²,

Yarimoglu³

et al. 2017

Klimik Dergisi

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A 66-year-old woman was admitted to our clinic with fever and swelling in her neck. She was unresponsive to empiric antibiotic treatment with cefuroxime axetil given for upper respiratory tract infection in a different center. She reported a tick bite on her neck one week before development of symptoms. On physical examination, there was an ulcerative nodular lesion on posterior cervical region together with regional lymphadenopathy. A positive titer of 1/160 was detected by Francisella tularensis microagglutination test. Ulceroglandular form of tularemia was diagnosed and oral doxycycline 2×100 mg was started. She was discharged with cure after a treatment of two weeks. As this case exemplified, tularemia forms other than oropharyngeal form which is most prevalent in Turkey can be encountered among patients with fever and lymphadenopathy in endemic areas. Klimik Dergisi 2017; 30(2): 83-6.

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“…Tularemia caused by type B is much less severe than tularemia caused by type A, and fatal cases are rare in type B (1). In Turkey, the most common form of tularemia is oropharyngeal, caused by the subspecies holarctica (2,3).…”

Section: Introductionmentioning

confidence: 99%

Prospective investigation of the hypothalamo–pituitary–adrenalaxis in patients with tularemia

Demiraslan¹,

Şimşek²,

Tanrıverdi³

et al. 2015

Turk J Med Sci

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IntroductionTularemia is a bacterial zoonotic diseases caused by Francisella tularensis. It exhibits different clinical manifestations depending on bacterial subspecies, such as Francisella subspecies tularensis (type A) or holarctica (type B), and the route of transmission, such as by arthropod bites, inhalation, or the ingestion of contaminated water or food. Tularemia caused by type B is much less severe than tularemia caused by type A, and fatal cases are rare in type B (1). In Turkey, the most common form of tularemia is oropharyngeal, caused by the subspecies holarctica (2,3).The adrenal glands are affected in sepsis, brucellosis, and tuberculosis. Variations in adrenal response to tularemia are most prominent in volunteers with typical acute illness, and adrenal response is minimal or absent in those with mild symptoms (4,5). Sepsis-associated abnormal pituitary response may explain some factors, including anatomic damage, acute inflammation, and drug-related cell dysfunction (5). The hypothalamopituitary-adrenal (HPA) axis may become severely dysfunctional during sepsis (5-7). In the past, the adrenal response of acute tularemia patients has been examined in healthy volunteers ( 8), but it is unclear whether there is a permanent adrenal insufficiency in the postinfectious period. The aim of this study was to investigate the HPA axis by adrenocorticotropic hormone (ACTH) stimulation test in acute tularemia and after therapy in a prospective study. Materials and methodsAdult tularemia patients who attended Erciyes University's Department of Infectious Diseases between 2011 and 2013 were included in this study. The study was approved by the local ethics committee, and informed consent was obtained from each patient. Tularemia was diagnosed in patients who had findings and symptoms compatible with tularemia, such as fever, sore throat, conjunctivitis, lymphadenopathy, cough and malaise, and tularemia microagglutination titer (MAT) of ≥1/128 or a 4-fold increase in titer after 4 weeks. Three of 6 clinical forms of tularemia were defined including oropharyngeal, oculoglandular, and glandular (1,2). Patients who were Background/aim: To investigate prospectively the hypothalamo-pituitary-adrenal (HPA) axis by adrenocorticotropic hormone (ACTH) stimulation test.Materials and methods: Tularemia was diagnosed according to guidelines. An ACTH stimulation test (1 µg) and a dexamethasone suppression test (DST; 1 mg) were performed in patients in the acute phase of tularemia before antibiotic treatment and in the chronic phase.Results: Nineteen patients (mean age: 41.0 ± 13.2 years; 57.9% female) with tularemia were enrolled in the study in 2011 and 2012. Cortisol response to ACTH stimulation test was sufficient in all patients during the acute phase. After the DST, the cortisol was not suppressed during the acute phase in only one patient. The median control time of 11 patients after acute tularemia was 13 months. During the chronic phase, cortisol response to ACTH stimulation was normal in all patients, and after DST ...

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Tularemia in Central Anatolia

Cited by 44 publications

References 22 publications

Epidemiology of Tularemia

Epidemiology of Tularemia

Delayed Diagnosis of Ulceroglandular Tularemia: A Case Report

Prospective investigation of the hypothalamo–pituitary–adrenalaxis in patients with tularemia

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