Tularemia

Question 1

Etiology

Answer 1

Francisella tularensis,typesAandB.A

After inoculation into skin,mucous membrane,lung ( i n h a l a t i o n ) , o r G I t r a c t .

Lymphatic spread

Question 2

Transmission

Answer 2

Bite of insect vector (ticks, deer flies, body lice, or other arthropods

Question 3

Most cases occur in what months

Answer 3

June to sept

Question 4

Reservoir

Answer 4

Rabbits, hares, muskrats, squirrels, voles, and beavers

Question 5

Clinical manifestation

Answer 5

About 48 h a er inoculation, pruritic papule developsatthesiteo traumaorinsectbite
ollowedbyenlargemento theregionallymph nodes. Fever to 41°C.
Inoculation site: Erythematous tender papule evolving to a vesicopustule, enlarging to crusted ulcer with raised, sharply demarcated margins (96 h) (Fig. 25-63). Depressed center thatiso encoveredbyablackeschar(chancri-
orm). Primary lesion on the nger or hand at thesiteo traumaorinsectbite;groinoraxilla a ertickbite

Question 6

Conjunctivae inoculation lesions

Answer 6

oculoglandular tularemia,
F. tularensis is inoculated into conjunctiva, causing a purulent conjunctivitis with pain, edema, and congestion. Small yellow nodules occur on conjunctivae and ulcerate

Question 7

Mortality rate if treated and untreated.

Answer 7

Untreated, mortality rate or ulceroglandular form is 5%;

1% if therapy is initiated promptly

Question 8

Tx

Answer 8

Streptomycin is the treatment of choice.

Also gentamycin, chloramphenicol, doxycycline, and cipro oxacin