title: Evaluation of tularemia cases focusing on the oculoglandular form.
abstract: BACKGROUND
  Tularemia is a zoonotic disease caused by Francisella tularensis. The oculoglandular form is one of the rarest forms. In this study, evaluated tularemia patients, focusing on the ocular form and the efficacy of early antibiotic therapy.
  
  
  METHODS
  During a tularemia outbreak, the epidemiological and clinical findings, laboratory assays, and drugs used for the treatment of 48 patients were recorded prospectively. The diagnosis of tularemia was confirmed with microagglutination test (MAT) as well as clinical findings.
  
  
  RESULTS
  The mean age of the subject was 48.6 years; 23 (47.9%) of them were female. Thirty-six (81.25%) patients had clinical presentation compatible with oropharyngeal tularemia, seven (14.58%) with oculoglandular tularemia, and two (4.1%) with ulceroglandular tularemia. The most common symptoms were fever (91.6%) and sore throat (81.2%), and the most common findings were lymphadenopathy (91.6%) and tonsillopharyngitis (81.2%). In the oculoglandular form, fever, lymphadenopathy, periorbital edema, conjunctival injection, and chemosis were found. The most distinctive ophthalmic feature was follicular conjunctivitis and conjunctival epithelial defects. Forty-five cases had positive serological results with MAT. All the patients were treated with antibiotics considered effective against F. tularensis, and topical antimicrobial treatment was given to the patients with oculoglandular tularemia. Twenty-six (54.16%) patients, who were admitted within three weeks of the onset of symptoms, recovered without sequel.
  
  
  CONCLUSIONS
  During tularemia outbreaks, ocular involvement should be considered carefully. The early administration of appropriate treatment will be more effective in resolving the infection and preventing complications. Along with systemic antibiotic therapy, topical treatment will help recovery.
authors.affiliation: Ankara Numune Training and Research Hospital, Ankara, Turkey. sebnemeren@yahoo.com.
authors.forename: Sebnem
authors.initials: S
authors.lastname: Eren Gok
authors.forename: Aysel
authors.initials: A
authors.lastname: Kocagul Celikbas
authors.forename: Nurcan
authors.initials: N
authors.lastname: Baykam
authors.forename: Ayse
authors.initials: A
authors.lastname: Atay Buyukdemirci
authors.forename: Mustafa Necati
authors.initials: MN
authors.lastname: Eroglu
authors.forename: Ozlem
authors.initials: O
authors.lastname: Evren Kemer
authors.forename: Basak
authors.initials: B
authors.lastname: Dokuzoguz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000372:Agglutination Tests; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D005128:Eye Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D005260:Female; D005604:Francisella tularensis / Q000302:isolation & purification*; D006801:Humans; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014406:Tularemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents