Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases.
Tularemia is a zoonotic disease caused by Francisella tularensis. We aimed to explicate the clinical and laboratory findings of 27 consecutive tularemia patients who were included into the study. The average duration between onset of symptoms and diagnosis was 19.1 +/- 7.3 days. Sore throat (100%), fever (93%) and myalgia (100%) were the most frequently observed symptoms, while lymphadenopathy (100%), pharyngeal hyperemia (85%), tonsillitis (74%), and rash (7%) were the most frequently observed physical findings. Treatment failed in 6 patients: 1/13 streptomycin- (changed to doxycycline + streptomycin), 1/7 ciprofloxacin- (changed to streptomycin), and 4/7 gentamicin- (changed to streptomycin) receiving patients who had longer duration to treatment (26.5 +/- 2.9 days) than the 21 successfully treated cases (17.0 +/- 6.8 days). Tularemia should to be taken into account in the differential diagnosis in cases having tonsillopharyngitis and cervical lymphadenopathy without response to beta lactam/macrolide-group antibiotics in rural areas. We believe that streptomycin should be the first-line antibiotic in the treatment of pediatric tularemia cases, but it should be supported by comprehensive studies with larger patient series.
Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
Ali
A
Kaya
Köksal
K
Deveci
Ismail Onder
IO
Uysal
Ahmet Sami
AS
Güven
Mevlüt
M
Demir
Elif Bilge
EB
Uysal
Asim
A
Gültekin
Füsun Dilara
FD
Içağasioğlu
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D008206:Lymphatic Diseases / Q000382:microbiology; D008297:Male; D010612:Pharyngitis / Q000382:microbiology; D012189:Retrospective Studies; D014069:Tonsillitis / Q000382:microbiology; D014406:Tularemia / Q000175:diagnosis* / Q000188:drug therapy*; D014421:Turkey
D000900:Anti-Bacterial Agents