title: Tularemia pneumonia in Oklahoma, 1982-1987.
abstract: OBJECTIVE
  We assessed the incidence, risk factors, and prognostic implications of tularemia pneumonia in Oklahoma from 1982 through 1987.
  
  
  METHODS
  We retrospectively reviewed all reported case-patients over the six-year period 1982-1987.
  
  
  METHODS
  Department of Health in Oklahoma, where tularemia is known to be endemic.
  
  
  METHODS
  Of 128 patients with tularemia who entered the study, 32 had pulmonary involvement.
  
  
  RESULTS
  Compared to patients without pulmonary involvement, those with tularemia pneumonia were older (52 vs 32, p less than .0001), less likely to give a history of vector exposure (25% vs 7%, p less than .05), more likely to present with typhoidal illness (56% vs 15%, p less than .0001), hospitalized longer (11.6 vs 4.7 days, p less than .001), more likely to have a positive culture (9 vs 7, p less than .01), and more likely to die (4 vs 1, p less than .01).
  
  
  CONCLUSIONS
  Patients with tularemia pneumonia often present without historical or physical examination findings that suggest the diagnosis; thus, tularemia pneumonia often cannot be distinguished from other cases of community-acquired pneumonia. Therefore, especially in areas where the disease is endemic, tularemia must be considered in patients with pneumonia.
authors.affiliation: Section of Endocrinology, University of Oklahoma College of Medicine, Oklahoma City 73104.
authors.forename: R H
authors.initials: RH
authors.lastname: Scofield
authors.forename: E J
authors.initials: EJ
authors.lastname: Lopez
authors.forename: S J
authors.initials: SJ
authors.lastname: McNabb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies; D012621:Seasons; D014406:Tularemia / Q000453:epidemiology* / Q000635:transmission