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Tularemia

Jon S. Parham, DO, MPH, FAAFP Reviewed 06/2019
 


BASICS

Zoonotic infection caused by two subspecies of the bacterium Francisella (Francisella tularensis [70% of cases in North America] and Francisella holarctica

DESCRIPTION

  • Life-cycle components

    • Gr...

DIAGNOSIS

HISTORY

  • History of potential contact with known vectors, reservoirs (e.g., game animals, pets, wild rodents), lab exposure, or exposure to infected materials such as water or hay

  • Explore leisu...

TREATMENT

Pediatric Considerations

Use aminoglycosides and quinolones with caution.

 
Pregnancy Considerations

Use aminoglycosides and quinolones with caution.

 

GENERAL MEASURES

  • Contact and respiratory drop...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitor hearing if long-term aminoglycoside therapy.

  • Monitor renal function during long-term therapy with aminoglycosides or quinolones.

DIET

As to...

REFERENCES

1
Hofinger DM, Cardona L, Mertz GJ, et al. Tularemic meningitis in the United States. Arch Neurol.  2009;66(4):523–527. [View Abstract on OvidMedline]
2
Maurin M, Castan B, Roch N, et al....

ADDITIONAL READING

  • Adams DA, Gallagher KM, Jajosky RA, et al; for Division of Notifiable Diseases and Healthcare Information, Office of Surveillance, Epidemiology, and Laboratory Services, CDC. Summar...

CODES

ICD10

  • A21.9 Tularemia, unspecified

  • A21.0 Ulceroglandular tularemia

  • A21.1 Oculoglandular tularemia

  • A21.8 Other forms of tularemia

  • A21.3 Gastrointestinal tularemia

  • A21.2 Pulmonary tularemia

  • A21.7 General...

CLINICAL PEARLS

  • A high index of suspicion is required to diagnose tularemia.

  • If bioterrorism is suspected, contact authorities and coordinate rapid diagnostic testing through the Laboratory Response Ne...

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