title: [Laboratory diagnosis and serologic course in patients with tularemia].
abstract: BACKGROUND
  Tularemia was practically unknown in Spain until the end of 1997, when an epidemic outbreak was declared. This paper presents the data on microbiological diagnosis of 55 patients who suffered from tularemia.
  
  
  METHODS
  Thirty-two samples from 19 patients and 151 serum samples from 55 patients were obtained for culture. Serologic diagnosis was performed by tube sero-agglutination and microagglutination. Three types of tests were performed on all sera: Wright sero-agglutination (WSA), Coombs test against Brucella spp. and sero-agglutination against Yersinia enterocolitica O:3, Yersinia enterocolitica O:3, and Proteus OX 19.
  
  
  RESULTS
  F. tularensis was found in two samples (6.25%) of the 32 received. Titers > or = 1/160 were obtained in 78.2% and 74.5% of the initial sera by tube sero-agglutination and microagglutination, respectively. Correlation between the two tests was 0.80 (p < 0.001). Prozone phenomenon was observed in 59.9% of the sera, while crossed reactivity to Brucella spp. and Proteus spp. was found in 9.3% and 22.8%, respectively. No crossed reactivity was observed with Yersinia spp.
  
  
  CONCLUSIONS
  Culture of F. tularensis has low sensitivity. The correlation obtained between tube sero-agglutination and microagglutination is good. Both techniques are useful in routine diagnosis of tularemia, although microagglutination has some advantages over tube agglutination.
authors.affiliation: Departamento de Microbiología, Hospital Universitario de Valladolid.
authors.forename: A I
authors.initials: AI
authors.lastname: Dueñas
authors.forename: M
authors.initials: M
authors.lastname: Ortega
authors.forename: I
authors.initials: I
authors.lastname: Garrote
authors.forename: M
authors.initials: M
authors.lastname: de Frutos
authors.forename: P
authors.initials: P
authors.lastname: Gutiérrez
authors.forename: A
authors.initials: A
authors.lastname: García-Pascual
authors.forename: M
authors.initials: M
authors.lastname: Cuervo
authors.forename: B
authors.initials: B
authors.lastname: Hernández Novoa
authors.forename: M A
authors.initials: MA
authors.lastname: Bratos
authors.forename: A
authors.initials: A
authors.lastname: Almaraz
authors.forename: A
authors.initials: A
authors.lastname: Orduña
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Torres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests; D014406:Tularemia / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology
chemical_list: D000907:Antibodies, Bacterial