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Tularemia

Saira Ajmal, MD and Chandler Walsh, DO Reviewed 04/2024
 


BASICS

Zoonotic infection caused by the aerobic gram-negative coccobacillus Francisellatularensis  

DESCRIPTION

  • Routes of Transmission

    • Insect bite

      • Arthropod vectors: ticks, flies, mosquitos

    • Handling of inf...

DIAGNOSIS

HISTORY

  • Explore leisure activities and recent travel history. Evaluate exposure history of contact with known vectors and reservoirs (e.g. game animals, free-roaming pets, wild rodents), lab ...

TREATMENT

Pediatric Considerations

Doxycycline is not recommended. Use aminoglycosides and quinolones with caution .

 
Pregnancy Considerations

Use aminoglycosides and quinolones with caution.

 

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Serology should be repeated 2-4 weeks after initial presentation to confirm the diagnosis 

Patient Monitoring

  • Monitor for signs of ototoxicity if long-term aminogly...

REFERENCES

1
Nelson CA, Winberg J, Bostic TD, et al. Systematic Review: Clinical Features, Antimicrobial Treatment, and Outcomes of Human Tularemia, 1993-2023. Clin Infect Dis. 2024;78(Suppl 1):S15-S28...

ADDITIONAL READING

Centers for Disease Control and Prevention. Tularemia. http://www.cdc.gov/tularemia. Accessed February 4, 2024.  

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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