Research Article
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Year 2018, , 147 - 152, 31.03.2018
https://doi.org/10.17546/msd.408631

Abstract

References

  • 1. Petersen JM, Mead PS, Schriefer ME. Francisella tularensis: an arthropod-borne pathogen. Vet Res. 2009;40(2):07.
  • 2. Ellis J, Oyston PC, Green M, Titball RW. Tularemia. Clin Microbiol Rev. 2002; 15(4): 631-46.
  • 3. Berger S. Tularemia: Global Status: 2017 edition. Global Infectious Disease and Epidemiology Network (GIDEON). http://www.gideononline.com.
  • 4. Sjöstedt A. Tularemia: history, epidemiology, pathogen physiology, and clinical manifestations. Ann N Y Acad Sci. 2007;1105:1-29.
  • 5. Maurin M. New anti-infective strategies for treatment of tularemia. Front Cell Infect Microbiol. 2014; 4: 115.
  • 6. Penn RL. Francisella tularensis (Tularemia) In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett's principles and practice of infectious diseases. 4th ed. New York: Churchill Ligingstone; 1995. 2060–2068.
  • 7. Kilic S, Yesilyurt M. Tularemi: Güncel Tedavi Seçeneklerine Genel Bir Bakış Tularemia: A General Overview on Current Treatment Options. Klimik Dergisi 2011;24(1): 2-10.
  • 8. Tärnvik A, Berglund L. Tularemia. Eur Respir J. 2003; 21(2): 361-73.
  • 9. WHO Guidelines on Tularaemia [İnternet]. Geneva: World Health Organization. http://www.who.int/csr/resources/publications/WHO_CDS_EPR_2007_7.pdf.
  • 10. Tärnvik A, Sandström G, Sjöstedt A. Infrequent manifestations of tularaemia in Sweden. Scand J Infect Dis. 1997;29:443-6.
  • 11. Tärnvik A, Chu MC. New approaches to diagnosis and therapy of tularemia. Ann N Y Acad Sci. 2007; 1105: 378-404.
  • 12. Sahin M, Atabay HI, Bicakci Z, Unver A, Otlu S. Outbreaks of tularemia in Turkey. Kobe J Med Sci. 2007;53:37-42.
  • 13. Ozdemir D, Sencan I, Annakkaya AN, Karadenizli A, Guclu E, Sert E, Emeksiz M, Kafali A. Comparison of the 2000 and 2005 outbreaks of tularemia in the Duzce region of Turkey. Jpn J Enfect Dis. 2007;60:51-2.
  • 14. Celebi G, Baruonu F, Ayoglu F, Cinar F, Karadenizli A, Ugur MB, Gedikoğlu S. Tularemia, a reemerging disease in northwest Turkey: epidemiological investigation and evaluation of treatment responses. Jpn J Infect Dis. 2006;59:229-34.
  • 15. Meric M, Sayan M, Willke A, Gedikoglu S. Su kaynaklı küçük bir tularemi salgını. Mikrobiyol Bul. 2008;42:49-59.
  • 16. Helvaci S, Gedikoglu S, Akalin H, Oral B. Tularemia in Bursa, Turkey: 205 cases in ten years. Eur J Epidemiol. 2000;16:271-6.
  • 17. Erdem H, Engin DO, Yesilyurt M, Karabay O, Elaldi N, Celebi G, Korkmaz N, Guven T, Sumer S, Tulek N, et al. Evaluation of tularaemia courses: a multicentre study from Turkey Clin Microbiol Infect. 2014;20:1042-1051.
  • 18. Tezer MS, Ovet G , Alatas N , Gorgulu MH, Koç E , Ozturk MA. Clinical Manifestations of 16 Oropharyngeal Tularemia Patients: Experience Of A Referral Hospital İn The City Of Konya, Turkey. Turk J Med Sci. 2013;43:227-23.
  • 19. Sencan I, Sahin I, Kaya D, Oksuz S,Ozdemir D, Karabay O. An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side. Yonsei Med J. 2009 Feb 28;50(1):50–54.
  • 20. Jacobs RF. Fauci AS, Braunwald F, Isselbach RJ, Wilson JD, Martin JB, Kasper DL. Harrison's principles of internal medicine. New York: Mc Graw-Hill; 1998. Tularemia; pp. 971–975.
  • 21. Syrjälä H, Schildt R, Räisäinen S. In vitro susceptibility of Francisella tularensis to fluoroquinolones and treatment of tularemia with norfloxacin and ciprofloxacin. Eur J Clin Microbiol Infect Dis. 1991 Feb; 10(2):68-70.
  • 22. Dikici N, Ural O, Sumer S, Ozturk K. Konya bölgesinde tularemia. Mikrobiyol Bul. 2012;46:225-35.
  • 23. Bevanger L, Maeland JA, Naess AI. Agglutinins and antibodies to Francisella tularensis outer membrane antigens in the early diagnosis of disease during an outbreak of tularemia. J Clin Microbiol. 1988; 26: 433-7.
  • 24. Schmitt P, Splettstosser W, Porsch-Ozcurumez M, Finke EJ, Grunow R. A novel screening ELISA and a confirmatory Western blot useful for diagnosis and epidemiological studies of tularemia. Epidemiol Infect. 2005; 133:759-66.
  • 25. Bevanger L, Maeland JA, Kvan AI. Comparative analysis of antibodies to Francisella tularensis antigens during the acute phase of tularemia and eight years later. Clin Diagn Lab Immunol. 1994;1:238-40
  • 26. Ikäheimo I, Syrjälä H, Karhukorpi J, Schildt R, Koskela M. In vitro antibiotic susceptibility of Francisella tularensis isolated from humans and animals. J Antimicrob Chemother. 2000; 46(2): 287-90.
  • 27. García del Blanco N, Gutiérrez Martín CB, de la Puente Redondo VA, Rodríguez Ferri EF. In vitro susceptibility of field isolates of Francisella tularensis subsp. holarctica recovered in Spain to several antimicrobial agents. Res Vet Sci. 2004; 76(3): 195-8.
  • 28. U.S.Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Biosafety in Microbiological and Biomedical Laboratories, 1999, 4th ed. U.S. Government Printing Office, Washington
  • 29. Yesilyurt M, Kiliç S, Celebi B, Celik M, Gül S, Erdogan F, Ozel G. Antimicrobial susceptibilities of Francisella tularensis subsp. holarctica strains isolated from humans in the Central Anatolia region of Turkey. J Antimicrob Chemother. 2011 Nov;66(11):2588-92.
  • 30. Meric M, Willke A, Finke EJ, Grunow R, Sayan M, Erdogan S, Gedikoglu S. Evaluation of clinical, laboratory, and therapeutic features of 145 tularemia cases: the role of quinolones in oropharyngeal tularemia. APMIS. 2008; 116(1): 66-73.
  • 31. Tuncer E, Onal B, Simsek G, Elagoz S, Sahpaz A, Kilic S, Altuntas EE, Ulu Kilic A. Tularemia: potential role of cytopathology in differential diagnosis of cervical lymphadenitis: multicenter experience in 53 cases and literature review. APMIS. 2014 Mar;122(3):236-42.

Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?

Year 2018, , 147 - 152, 31.03.2018
https://doi.org/10.17546/msd.408631

Abstract



Background: Tularemia is a bacterial,
zoonotic disease caused by Francisella tularensis. Although
the ulceroglandular form is the most common form in the world, oropharyngeal
tularemia is the most common form in Turkey. Lymph node suppuration is
the most common complication. F. tularensis causes granulomatous and suppurative lesions in the lymph nodes and
other organs.

Methods: Seventeen suspected
oropharyngeal form tularemia cases complicated with suppurated lymphadenitis
have been examined in this study. All of the patients (17, 100%) had cervical
lymphadenopathies and had a history of beta-lactam antibiotic use with the
diagnosis of tonsillitis. Tularemia cases were diagnosed according to the case
definition of World Health Organization (WHO).

Results: All of the patients (17, 100%) had cervical lymphadenopathies ranging in
size from 2-8 cm and unilateral lymphadenopathy, while 12 (71%) patients had
right-sided lymphadenopathy. The rate of fever was 41% and the rate of
pharyngitis or tonsillitis was 52% at presentation. All patients had a history
of beta-lactam antibiotic use with the diagnosis of tonsillitis. Seven patients
recovered with first-line monotherapy. In the remaining 10 patients, treatment
was rearranged, and these patients were switched to combination treatment or another
anti-infective. Surgical drainage was performed on all but two of the patients.







Conclusions: The diagnosis of tularemia is often delayed. It may take a
significant length of time to diagnose the condition and the disease may become
complicated.
As it is understood
from our study and other studies, the types and duration of treatment can vary
and differences can be observed in cases that are past the acute stage.
Although the guideline has included a classical treatment approach for the
tularemia, there is no standard approach to cases with delayed diagnosis,
complicated cases and those refractory to conventional regimens. These
observations and other examinations have raised the question whether the
chronic form of tularemia should be defined, and whether the treatment options
and durations should be re-standardized according to the ‘chronic tularemia’
definition as a ‘chronic granulomatous disease’

References

  • 1. Petersen JM, Mead PS, Schriefer ME. Francisella tularensis: an arthropod-borne pathogen. Vet Res. 2009;40(2):07.
  • 2. Ellis J, Oyston PC, Green M, Titball RW. Tularemia. Clin Microbiol Rev. 2002; 15(4): 631-46.
  • 3. Berger S. Tularemia: Global Status: 2017 edition. Global Infectious Disease and Epidemiology Network (GIDEON). http://www.gideononline.com.
  • 4. Sjöstedt A. Tularemia: history, epidemiology, pathogen physiology, and clinical manifestations. Ann N Y Acad Sci. 2007;1105:1-29.
  • 5. Maurin M. New anti-infective strategies for treatment of tularemia. Front Cell Infect Microbiol. 2014; 4: 115.
  • 6. Penn RL. Francisella tularensis (Tularemia) In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett's principles and practice of infectious diseases. 4th ed. New York: Churchill Ligingstone; 1995. 2060–2068.
  • 7. Kilic S, Yesilyurt M. Tularemi: Güncel Tedavi Seçeneklerine Genel Bir Bakış Tularemia: A General Overview on Current Treatment Options. Klimik Dergisi 2011;24(1): 2-10.
  • 8. Tärnvik A, Berglund L. Tularemia. Eur Respir J. 2003; 21(2): 361-73.
  • 9. WHO Guidelines on Tularaemia [İnternet]. Geneva: World Health Organization. http://www.who.int/csr/resources/publications/WHO_CDS_EPR_2007_7.pdf.
  • 10. Tärnvik A, Sandström G, Sjöstedt A. Infrequent manifestations of tularaemia in Sweden. Scand J Infect Dis. 1997;29:443-6.
  • 11. Tärnvik A, Chu MC. New approaches to diagnosis and therapy of tularemia. Ann N Y Acad Sci. 2007; 1105: 378-404.
  • 12. Sahin M, Atabay HI, Bicakci Z, Unver A, Otlu S. Outbreaks of tularemia in Turkey. Kobe J Med Sci. 2007;53:37-42.
  • 13. Ozdemir D, Sencan I, Annakkaya AN, Karadenizli A, Guclu E, Sert E, Emeksiz M, Kafali A. Comparison of the 2000 and 2005 outbreaks of tularemia in the Duzce region of Turkey. Jpn J Enfect Dis. 2007;60:51-2.
  • 14. Celebi G, Baruonu F, Ayoglu F, Cinar F, Karadenizli A, Ugur MB, Gedikoğlu S. Tularemia, a reemerging disease in northwest Turkey: epidemiological investigation and evaluation of treatment responses. Jpn J Infect Dis. 2006;59:229-34.
  • 15. Meric M, Sayan M, Willke A, Gedikoglu S. Su kaynaklı küçük bir tularemi salgını. Mikrobiyol Bul. 2008;42:49-59.
  • 16. Helvaci S, Gedikoglu S, Akalin H, Oral B. Tularemia in Bursa, Turkey: 205 cases in ten years. Eur J Epidemiol. 2000;16:271-6.
  • 17. Erdem H, Engin DO, Yesilyurt M, Karabay O, Elaldi N, Celebi G, Korkmaz N, Guven T, Sumer S, Tulek N, et al. Evaluation of tularaemia courses: a multicentre study from Turkey Clin Microbiol Infect. 2014;20:1042-1051.
  • 18. Tezer MS, Ovet G , Alatas N , Gorgulu MH, Koç E , Ozturk MA. Clinical Manifestations of 16 Oropharyngeal Tularemia Patients: Experience Of A Referral Hospital İn The City Of Konya, Turkey. Turk J Med Sci. 2013;43:227-23.
  • 19. Sencan I, Sahin I, Kaya D, Oksuz S,Ozdemir D, Karabay O. An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side. Yonsei Med J. 2009 Feb 28;50(1):50–54.
  • 20. Jacobs RF. Fauci AS, Braunwald F, Isselbach RJ, Wilson JD, Martin JB, Kasper DL. Harrison's principles of internal medicine. New York: Mc Graw-Hill; 1998. Tularemia; pp. 971–975.
  • 21. Syrjälä H, Schildt R, Räisäinen S. In vitro susceptibility of Francisella tularensis to fluoroquinolones and treatment of tularemia with norfloxacin and ciprofloxacin. Eur J Clin Microbiol Infect Dis. 1991 Feb; 10(2):68-70.
  • 22. Dikici N, Ural O, Sumer S, Ozturk K. Konya bölgesinde tularemia. Mikrobiyol Bul. 2012;46:225-35.
  • 23. Bevanger L, Maeland JA, Naess AI. Agglutinins and antibodies to Francisella tularensis outer membrane antigens in the early diagnosis of disease during an outbreak of tularemia. J Clin Microbiol. 1988; 26: 433-7.
  • 24. Schmitt P, Splettstosser W, Porsch-Ozcurumez M, Finke EJ, Grunow R. A novel screening ELISA and a confirmatory Western blot useful for diagnosis and epidemiological studies of tularemia. Epidemiol Infect. 2005; 133:759-66.
  • 25. Bevanger L, Maeland JA, Kvan AI. Comparative analysis of antibodies to Francisella tularensis antigens during the acute phase of tularemia and eight years later. Clin Diagn Lab Immunol. 1994;1:238-40
  • 26. Ikäheimo I, Syrjälä H, Karhukorpi J, Schildt R, Koskela M. In vitro antibiotic susceptibility of Francisella tularensis isolated from humans and animals. J Antimicrob Chemother. 2000; 46(2): 287-90.
  • 27. García del Blanco N, Gutiérrez Martín CB, de la Puente Redondo VA, Rodríguez Ferri EF. In vitro susceptibility of field isolates of Francisella tularensis subsp. holarctica recovered in Spain to several antimicrobial agents. Res Vet Sci. 2004; 76(3): 195-8.
  • 28. U.S.Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Biosafety in Microbiological and Biomedical Laboratories, 1999, 4th ed. U.S. Government Printing Office, Washington
  • 29. Yesilyurt M, Kiliç S, Celebi B, Celik M, Gül S, Erdogan F, Ozel G. Antimicrobial susceptibilities of Francisella tularensis subsp. holarctica strains isolated from humans in the Central Anatolia region of Turkey. J Antimicrob Chemother. 2011 Nov;66(11):2588-92.
  • 30. Meric M, Willke A, Finke EJ, Grunow R, Sayan M, Erdogan S, Gedikoglu S. Evaluation of clinical, laboratory, and therapeutic features of 145 tularemia cases: the role of quinolones in oropharyngeal tularemia. APMIS. 2008; 116(1): 66-73.
  • 31. Tuncer E, Onal B, Simsek G, Elagoz S, Sahpaz A, Kilic S, Altuntas EE, Ulu Kilic A. Tularemia: potential role of cytopathology in differential diagnosis of cervical lymphadenitis: multicenter experience in 53 cases and literature review. APMIS. 2014 Mar;122(3):236-42.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Yesim Alpay This is me

Publication Date March 31, 2018
Published in Issue Year 2018

Cite

APA Alpay, Y. (2018). Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?. Medical Science and Discovery, 5(3), 147-152. https://doi.org/10.17546/msd.408631
AMA Alpay Y. Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?. Med Sci Discov. March 2018;5(3):147-152. doi:10.17546/msd.408631
Chicago Alpay, Yesim. “Should the Chronic Form of Tularemia Be Defined? Should the Treatment of the Chronic Form Be Managed Differently?”. Medical Science and Discovery 5, no. 3 (March 2018): 147-52. https://doi.org/10.17546/msd.408631.
EndNote Alpay Y (March 1, 2018) Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?. Medical Science and Discovery 5 3 147–152.
IEEE Y. Alpay, “Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?”, Med Sci Discov, vol. 5, no. 3, pp. 147–152, 2018, doi: 10.17546/msd.408631.
ISNAD Alpay, Yesim. “Should the Chronic Form of Tularemia Be Defined? Should the Treatment of the Chronic Form Be Managed Differently?”. Medical Science and Discovery 5/3 (March 2018), 147-152. https://doi.org/10.17546/msd.408631.
JAMA Alpay Y. Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?. Med Sci Discov. 2018;5:147–152.
MLA Alpay, Yesim. “Should the Chronic Form of Tularemia Be Defined? Should the Treatment of the Chronic Form Be Managed Differently?”. Medical Science and Discovery, vol. 5, no. 3, 2018, pp. 147-52, doi:10.17546/msd.408631.
Vancouver Alpay Y. Should the chronic form of tularemia be defined? Should the treatment of the chronic form be managed differently?. Med Sci Discov. 2018;5(3):147-52.