title: Clinical and laboratory findings of tularemia: a retrospective analysis.
abstract: OBJECTIVE
  This study aims to define demographic characteristics and clinical and laboratory findings of the patients with tularemia and to assess the treatment outcomes.
  
  
  METHODS
  A total of 58 consecutive patients (26 males, 32 females; mean age 37±22 years; range 6 to 80 years) with tularemia were retrospectively analyzed in this study. Demographic characteristics, laboratory findings, physical examination findings and treatment outcomes were recorded.
  
  
  RESULTS
  Forty patients (86.2%) had glandular tularemia; seven (12.1%) had oropharyngeal tularemia, and one (1.7%) patient had oculoglandular tularemia. The most common symptoms were swollen neck lymph nodes high fever and sore throat. Fifty seven patients (98.2%) had swollen neck lymph nodes; 39 (67.2%) patients had high fever (67.2%) and 36 (62.1%) patients had sore throat. Complete recovery was obtained in 45 patients (77.6%), while 13 (22.4%) were unresponsive to the treatment. The most frequent laboratory findings were high level of C-reactive protein (CRP) and increased erythrocyte sedimentation rate (ESR). Mean leukocyte counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine levels were within normal range in all patients.
  
  
  CONCLUSIONS
  Tularemia should be differentiated from upper respiratory tract infections and cervical lymphadenopathy. The most commonly used hematological and biochemical assays do not provide significant benefits for the diagnosis of tularemia. However, increased level of ESR and CRP at one month may support the diagnosis. Early diagnosis and appropriate treatment may prevent therapeutic failure.
authors.affiliation: Department of Otolaryngology, Medicine Faculty of Gaziosmanpaşa University, Tokat, Turkey. drsemakoc@gmail.com
authors.forename: Sema
authors.initials: S
authors.lastname: Koç
authors.forename: Fazilet
authors.initials: F
authors.lastname: Duygu
authors.forename: Erkan
authors.initials: E
authors.lastname: Söğüt
authors.forename: Levent
authors.initials: L
authors.lastname: Gürbüzler
authors.forename: Ahmet
authors.initials: A
authors.lastname: Eyibilen
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aladağ
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000382:microbiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014406:Tularemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein