Çocuklarda Tularemi: Tularemili 15 Olgunun Klinik, Laboratuvar ve Tedavi Sonuçlarının Değerlendirilmesi

Yıl 2013, , 57 - 62, 01.09.2013

Solmaz Çelebi , Ekrem Koyuncu Şefika Elmas Bozdemir Benhur Şirvan Çetin Mustafa Kemal Hacımustafaoğlu

https://doi.org/10.4274/Jcp.11.24119

Öz

Girifl: Tularemi Francisella tularensis’in neden olduğu zoonotik hastalıktır. Bu çalışmanın amacı tularemi tanısı konan 15 çocuk olgunun klinik ve laboratuvar bulgularının değerlendirilmesidir. Gereç ve Yöntem: Çocuk Enfeksiyon Hastalıkları Polikliniğine ateş, boğaz ağrısı ve lenfadenopati LAP yakınması ile başvurup mikroaglütinasyon test MAT titresi 1/160 ve üstünde olan 15 olgu geriye dönük olarak değerlendirilerek sosyo-demografik özellikleri, hayvan ile temas ve kene ısırığı öyküleri, yakınma süreleri, klinik ve laboratuvar bulguları, tedavileri ve klinik gidişleri incelendi. Bulgular: Olguların yaş ortalaması 11,5±5,1 yıl 3-17 ve %53’ü erkek idi. Olguların %53,3’ü kırsal kesimde yaşıyor ve kuyu suyu kullanıyordu. En sık başvuru yakınmaları olan boyunda şişlik %93,3 , boğaz ağrısı %66,7 ve ateş yüksekliği %66,7 idi. Olgularda en sık orofarengeal tularemi %66,7 saptandı. Cerrahi olarak olguların %27’sinin LAP’si boşaltılırken, %13,3’ünde ise LAP kendi kendine drene olmuştu. Bulgular başladıktan sonraki ortalama başvuru süresi 53±45,3 5-150 gün bulundu. Başvuru öncesi olguların %60’ında betalaktam grubu antibiyotik alımı vardı. Lenf bezleri süpüre olan 6 olgunun başvuru ortancası 61 20- 150 gün, diğerlerinin ise 35 5-75 gün olarak saptandı p

Anahtar Kelimeler

Francisella tularensis, tularemi, çocuk

Tularemia in Children: Evaluation of Clinical, Laboratory and Treatment Outcomes of 15 Tularemia Cases

Öz

Introduction: Tularemia is a zoonotic diseases caused by Francisella tularensis. The aim of this study was to evaluate the clinical and laboratory findings of 15 children with the diagnosis of tularemia. Materials and Methods: Fifteen cases admitted with fever, sore throat, lymphadenopathy and a F. tularensis antibody titer of 1/160 and above in the microagglutination test MAT were evaluated retrospectively. Their sociodemographic characteristics, contact with animals, history of tick bite, duration of complaints, clinical and laboratory findings, treatments and clinical courses were studied. Results: The mean age of patients was 11.5±5.1 3-17 years and 61.3% were male. Fiftythree percent of the patients were living in rural areas, and had contact with contaminated water. Swelling in the neck 93.3% , sore throat 66.7% and fever 66.7% were the most frequently observed symptoms. Oropharyngeal tularemia 66.7% was predominated. In 27% of the patients LAPs were drained surgically, and in 13.3% of cases they were drained by itself. The mean duration between onset of tularemia symptoms and diagnosis was 53±45.3 5- 150 days. Sixty percent of patients were received beta-lactam-antibiotics before admission. It was noted that 6 patients with suppurative lymph nodes were admitted to hospital within median 61 20-150 days, while others were admitted within median 35 5-75 days p

Anahtar Kelimeler

Francisella tularensis, tularemia, child

Kaynakça

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