infectious diseases
Tularemia
Key Points
F. tularensisis a highly infectious organism; in the US and Canada, the main reservoir is wild rabbits, hares, and rodents. Tularemia can be acquired in many ways, including direct contact with infected animals (particularly rabbits and hares) or birds, bites of infected arthropods, inadvertent contact with laboratory specimens, or, rarely, inhalation of an infectious aerosol or ingestion of contaminated meat or water. Patients have a fever of 39.5 to 40°C and other constitutional symptoms (eg, headache, chills, nausea, vomiting, severe prostration) along with specific manifestations related to the organ affected; skin lesions and/or lymphadenitis are most common, and pneumonia may occur. Diagnose using cultures of blood and relevant clinical material; acute and convalescent antibody titers, polymerase chain reaction (PCR) testing, and certain staining techniques may also be helpful. Treat withstreptomycin(pluschloramphenicolfor meningitis). Take appropriate precautions in endemic areas, including tick avoidance strategies, use of protective gear while handling rabbits, hares, and rodents, and thorough cooking of wild birds and game. 