Abstract
Objectives: We describe some characteristics (epidemiologic, clinical, diagnostic and treatment features) of the disease. Methods: Epidemiological and clinical features of the patients with laboratory confirmed tularemia were reviewed retrospectively in Yozgat during two-year period. Results: In total 13 patients with tularemia were included into this study. The mean age was 33±15years (range10to58), ten of them were female. The duration of complaints before admission to hospital was 12 days. As possible risk factors; two patients were living in endemic rural area; seven cases used natural water and eight cases consumed infected meat. Oropharyngeal tularemia was diagnosed in all cases. Sore throat, chills, fever and cervical mass were the most common complaints of patients. Nine cases had enlarged lymphadenopathies bilaterally. Ciprofloxacin and doxycycline combination was the most common treatment. The patients received therapy for up to 21 days and were considered successfully treated in the follow up. Death or serious complications were not observed. Conclusion: Tularemia should be considered in patients presenting with lymphadenopathy, fever, sorethroat and unresponsive to beta-lactam. Therefore, healthcare workers and community should be educated for the risk factors of the disease.
References
- Ulu Kılıç A, Kılıç S, Sencan I, et al. A water borne tuleremia out- break caused by Francisella tularensis subspecies holarctica in Central Anatolia region. Mikrobiyol Bul 2011;45:234-247.
- Taş Bayhan G, Tanır G, Çelebi B. Two cases of glandular tula- remia from Turkey. Turkish J Pediatr 2012;54:203-206.
- Tarnik A, Berlund L. Tularemia. Eur Respir J 2003; 21: 361- 373.
- Gürcan S. Francisella tularensis and tularemia in Turkey. Mik- robiyol Bul 2007;41:621-636.
- Enderlin G, Morales L, Jacobs RF, et al. Streptomycin and alternative agents for the treatment of tularemia; review of the literature. Clin Infect Dis 1994;19:42-47.
- WHO Guidelines on tularemia 2007. Epidemic and pandemic alert and response http: //www.who.int/csr/resources/publi- cations/WHO_CDS_EPR_2007_7.pdf.
- Dikici N, Ural O, Sümer S, et al. Tularemia in Konya Region, Turkey. Mikrobiyol Bul 2012;46:225-235.
- http:/ www.saglik.gov.tr/ TR/ dosya/1-71840/h/ tularemi-saha- rehberi.pdf.
- Akalın H, Helvacı S, Gedikloglu S. Re-emergence of tularemia in Turkey. Int J Infect Dis 2009;13:547-551.
- Altuntas EE, Polat K, Durmus K, et al. Tularemia and the oculoglandular syndrome of Parinaud. Braz J Infect Dıs. 2012:16;90-91.
- Maurin M, Pellox I, Brion JP, et al. Human Tularemia in France, 2006-2010. Clin Infect Dis 2011;53:133-141.
- Komitova R, Nenova R, Padeshki P, et al. Tularemia in Bul- garia 2003-2004. J Infect Dev Ctries 2010;4:689-694.
- Celebi G, Baruönü F, Ayoğlu F, et al. Tularemia, a reemerg- ing disease in northwest Turkey: epidemiological investiga- tion and evaluation of treatment responses. Jpn J Infect Dis 2006;59:229-234.
- Tarnvik A, Berglund L. Tularemia. Eur Respir 2003;21:361- 373.
- Helvacı S, Gedikoglu S, Akalın H, et al. Tularemia in Bursa, Turkey: 205 cases in ten years. Eur J Epidemiol 2000;16:271- 276.
Abstract
Amaç: Tulareminin endemik olduğu bir bölgede hastaların epidemiyolojik, klinik, tanısal, tedavi özellikleri araştırıldı. Yöntemler: Yozgat bölgesinde iki yıllık süre içerisinde başvuran laboratuvar doğrulamalı Tularemi vakalarının epidemiyolojik ve klinik özellikleri retrospektif olarak değerlendirildi.Bulgular: Çalışmaya toplamda 13 tularemi hastası dahil edildi. Yaş ortalaması 33 ± 15 yıl bulundu. Hastaların onu kadındı. Ortalama inkübasyon süresi 12 gündür. Risk faktörü olarak hastaların 2’sinde endemik bölgede yaşama, 5’inde hayvancılıkla uğraşma öyküsü ve 5’inde de kaynak suyu kullanım öyküsü bulunmaktadır. Olgularda en sık orofaringeal tularemi görülmektedir. En sık başvuru şikayetleri boğaz ağrısı, üşüme-titreme, ateş, boyunda şişliktir. Hastaların dokuzunda bilateral, fluktuasyon veren lenf noduna rastlandı. Siprofloksasin+ doksisiklin en sık kullanılan tedavi seçeneklerindendir. Cerrahi olarak lenf nodu drenajı yapıldı. Yaklaşık 21 gün süreyle tedavi alan hastalarda, tedavi açısından başarılı yanıtlar alınırken, ciddi komplikasyon gelişen, mortal seyreden vaka olmadı. Sonuç: Özellikle servikal lenfadenopati, ateş, boğaz ağrısı ile başvuran ve beta-laktam tedavisine yanıtsız hastalarda Tularemi akılda bulundurulmalıdır. Bu nedenle, hastalığın yönetimi açısından, sağlık personeli ve toplumun Tularemi ve risk faktörleri açısından eğitilmesi gerekmektedir
References
- Ulu Kılıç A, Kılıç S, Sencan I, et al. A water borne tuleremia out- break caused by Francisella tularensis subspecies holarctica in Central Anatolia region. Mikrobiyol Bul 2011;45:234-247.
- Taş Bayhan G, Tanır G, Çelebi B. Two cases of glandular tula- remia from Turkey. Turkish J Pediatr 2012;54:203-206.
- Tarnik A, Berlund L. Tularemia. Eur Respir J 2003; 21: 361- 373.
- Gürcan S. Francisella tularensis and tularemia in Turkey. Mik- robiyol Bul 2007;41:621-636.
- Enderlin G, Morales L, Jacobs RF, et al. Streptomycin and alternative agents for the treatment of tularemia; review of the literature. Clin Infect Dis 1994;19:42-47.
- WHO Guidelines on tularemia 2007. Epidemic and pandemic alert and response http: //www.who.int/csr/resources/publi- cations/WHO_CDS_EPR_2007_7.pdf.
- Dikici N, Ural O, Sümer S, et al. Tularemia in Konya Region, Turkey. Mikrobiyol Bul 2012;46:225-235.
- http:/ www.saglik.gov.tr/ TR/ dosya/1-71840/h/ tularemi-saha- rehberi.pdf.
- Akalın H, Helvacı S, Gedikloglu S. Re-emergence of tularemia in Turkey. Int J Infect Dis 2009;13:547-551.
- Altuntas EE, Polat K, Durmus K, et al. Tularemia and the oculoglandular syndrome of Parinaud. Braz J Infect Dıs. 2012:16;90-91.
- Maurin M, Pellox I, Brion JP, et al. Human Tularemia in France, 2006-2010. Clin Infect Dis 2011;53:133-141.
- Komitova R, Nenova R, Padeshki P, et al. Tularemia in Bul- garia 2003-2004. J Infect Dev Ctries 2010;4:689-694.
- Celebi G, Baruönü F, Ayoğlu F, et al. Tularemia, a reemerg- ing disease in northwest Turkey: epidemiological investiga- tion and evaluation of treatment responses. Jpn J Infect Dis 2006;59:229-234.
- Tarnvik A, Berglund L. Tularemia. Eur Respir 2003;21:361- 373.
- Helvacı S, Gedikoglu S, Akalın H, et al. Tularemia in Bursa, Turkey: 205 cases in ten years. Eur J Epidemiol 2000;16:271- 276.
Details
| Primary Language | English |
|---|---|
| Journal Section | ART |
| Authors | |
| Publication Date | June 1, 2014 |
| Published in Issue | Year 2014 Volume: 4 Issue: 5 |