Tularemia: The Resurgence of a Diagnostic Challenge and Clinical Dilemma in the United States

Kelson, Michael; Burnett, Justin; Girgis, Sameh; Bakr, Mohamed H.

doi:10.7759/cureus.27363

Cited by 3 publications

(3 citation statements)

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“…Since the disease is more common during summer, clinicians should suspect the condition during this season (Kelson et al. 2022 ).…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

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Tularemia – a re-emerging disease with growing concern

Sharma,

Patil,

Singh

et al. 2023

Veterinary Quarterly

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Tularemia caused by Gram-negative, coccobacillus bacterium, Francisella tularensis, is a highly infectious zoonotic disease. Human cases have been reported mainly from the United States, Nordic countries like Sweden and Finland, and some European and Asian countries. Naturally, the disease occurs in several vertebrates, particularly lagomorphs. Type A (subspecies tularensis ) is more virulent and causes disease mainly in North America; type B (subspecies holarctica ) is widespread, while subspecies mediasiatica is present in central Asia. F. tularensis is a possible bioweapon due to its lethality, low infectious dosage, and aerosol transmission. Small mammals like rabbits, hares, and muskrats are primary sources of human infections, but true reservoir of F. tularensis is unknown. Vector-borne tularemia primarily involves ticks and mosquitoes. The bacterial subspecies involved and mode of transmission determine the clinical picture. Early signs are flu-like illnesses that may evolve into different clinical forms of tularemia that may or may not include lymphadenopathy. Ulcero-glandular and glandular forms are acquired by arthropod bite or handling of infected animals, oculo-glandular form as a result of conjunctival infection, and oro-pharyngeal form by intake of contaminated food or water. Pulmonary form appears after inhalation of bacteria. Typhoidal form may occur after infection via different routes. Human-to-human transmission has not been known. Diagnosis can be achieved by serology, bacterial culture, and molecular methods. Treatment for tularemia typically entails use of quinolones, tetracyclines, or aminoglycosides. Preventive measures are necessary to avoid infection although difficult to implement. Research is underway for the development of effective live attenuated and subunit vaccines.

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“…Since the disease is more common during summer, clinicians should suspect the condition during this season (Kelson et al. 2022 ).…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

“… 2021 ; Kelson et al. 2022 ). It is pertinent to mention that streptomycin is no longer available in many countries.…”

Section: Human Disease Managementmentioning

confidence: 99%

Tularemia – a re-emerging disease with growing concern

Sharma,

Patil,

Singh

et al. 2023

Veterinary Quarterly

View full text Add to dashboard Cite

show abstract

“…Auch beschränken wir uns in unseren Ausführungen auf die Indikation Depression, obwohl es zunehmend auch Evidenz für eine therapeutische Wirksamkeit von razemischen Ketamininfusionen bei anderen Indikationen wie z. B. Suchterkrankungen gibt [5,6]. Die von Herrn Prof. Bonnet vorgebrachte Empfehlung, die Durchführungs-, Sicherheits-und Überwachungsregeln einer Ketamininfusionstherapie an das jeweili-ge Setting und die jeweiligen Rahmenbedingungen anzupassen unterstützen wir unter Wahrung der in der Fachinformation des verwendeten Präparates beschriebenen Mindeststandardsausdrücklich, um möglichst vielen geeigneten Patienten:innen diese wirkungsvolle Therapie sicher zukommen lassen zu können.…”

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