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%),...
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| Veröffentlicht in: | Turkish journal of pediatrics 2012-03, Vol.54 (2), p.105-112 |
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| creator | Kaya, Ali Deveci, Köksal Uysal, Ismail Onder Güven, Ahmet Sami Demir, Mevlüt Uysal, Elif Bilge Gültekin, Asim Içağasioğlu, Füsun Dilara |
| description | 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. |
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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.</description><identifier>ISSN: 0041-4301</identifier><identifier>PMID: 22734295</identifier><language>eng</language><publisher>Turkey: Hacettepe University Faculty of Medicine</publisher><subject>Adolescent ; Anti-Bacterial Agents - therapeutic use ; Child ; Child, Preschool ; Female ; Fever - microbiology ; Humans ; Lymphatic Diseases - microbiology ; Male ; Pharyngitis - microbiology ; Retrospective Studies ; Tonsillitis - microbiology ; Tularemia - diagnosis ; Tularemia - drug therapy ; Turkey</subject><ispartof>Turkish journal of pediatrics, 2012-03, Vol.54 (2), p.105-112</ispartof><rights>Copyright Hacettepe University Faculty of Medicine Mar/Apr 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22734295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaya, Ali</creatorcontrib><creatorcontrib>Deveci, Köksal</creatorcontrib><creatorcontrib>Uysal, Ismail Onder</creatorcontrib><creatorcontrib>Güven, Ahmet Sami</creatorcontrib><creatorcontrib>Demir, Mevlüt</creatorcontrib><creatorcontrib>Uysal, Elif Bilge</creatorcontrib><creatorcontrib>Gültekin, Asim</creatorcontrib><creatorcontrib>Içağasioğlu, Füsun Dilara</creatorcontrib><title>Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases</title><title>Turkish journal of pediatrics</title><addtitle>Turk J Pediatr</addtitle><description>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.</description><subject>Adolescent</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Fever - microbiology</subject><subject>Humans</subject><subject>Lymphatic Diseases - microbiology</subject><subject>Male</subject><subject>Pharyngitis - microbiology</subject><subject>Retrospective Studies</subject><subject>Tonsillitis - microbiology</subject><subject>Tularemia - diagnosis</subject><subject>Tularemia - drug therapy</subject><subject>Turkey</subject><issn>0041-4301</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkM1KAzEYRWeh2Fp9BQm4ceFA8mUm07iTolUouKnr4UsmoSmZH_Mj9O2tWF24uptzD5d7VswprVhZccpmxWWMe0qhobK5KGYADa9A1vNit80eg-kdEjcQvXO-C2Z4IOYTfcbkxoGMlmjvBqfR3xOPagyYxnAgOHQk7UzAyeTkNLEGUw4mfhegIelPrDGaeFWcW_TRXJ9yUbw_P21XL-Xmbf26etyUE3CZykYp5ExIsQRdqaYWXIgOKyY7sGAlUKy51YIyi7qBJVNUq05YKbQ0qgbgi-LuxzuF8SObmNreRW28x8GMObaMAtS1FFV9RG__ofsxh-G4rmUcKgEUqDxSNycqq9507RRcj-HQ_n7IvwCzM2w4</recordid><startdate>201203</startdate><enddate>201203</enddate><creator>Kaya, Ali</creator><creator>Deveci, Köksal</creator><creator>Uysal, Ismail Onder</creator><creator>Güven, Ahmet Sami</creator><creator>Demir, Mevlüt</creator><creator>Uysal, Elif Bilge</creator><creator>Gültekin, Asim</creator><creator>Içağasioğlu, Füsun Dilara</creator><general>Hacettepe University Faculty of Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>EDSIH</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201203</creationdate><title>Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases</title><author>Kaya, Ali ; Deveci, Köksal ; Uysal, Ismail Onder ; Güven, Ahmet Sami ; Demir, Mevlüt ; Uysal, Elif Bilge ; Gültekin, Asim ; Içağasioğlu, Füsun Dilara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p239t-7bba3169682c4b756366da419d2f2f920a53fc601fac7281b0cbd6f96c9eb5223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Fever - microbiology</topic><topic>Humans</topic><topic>Lymphatic Diseases - microbiology</topic><topic>Male</topic><topic>Pharyngitis - microbiology</topic><topic>Retrospective Studies</topic><topic>Tonsillitis - microbiology</topic><topic>Tularemia - diagnosis</topic><topic>Tularemia - drug therapy</topic><topic>Turkey</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaya, Ali</creatorcontrib><creatorcontrib>Deveci, Köksal</creatorcontrib><creatorcontrib>Uysal, Ismail Onder</creatorcontrib><creatorcontrib>Güven, Ahmet Sami</creatorcontrib><creatorcontrib>Demir, Mevlüt</creatorcontrib><creatorcontrib>Uysal, Elif Bilge</creatorcontrib><creatorcontrib>Gültekin, Asim</creatorcontrib><creatorcontrib>Içağasioğlu, Füsun Dilara</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Turkey Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Turkish journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaya, Ali</au><au>Deveci, Köksal</au><au>Uysal, Ismail Onder</au><au>Güven, Ahmet Sami</au><au>Demir, Mevlüt</au><au>Uysal, Elif Bilge</au><au>Gültekin, Asim</au><au>Içağasioğlu, Füsun Dilara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases</atitle><jtitle>Turkish journal of pediatrics</jtitle><addtitle>Turk J Pediatr</addtitle><date>2012-03</date><risdate>2012</risdate><volume>54</volume><issue>2</issue><spage>105</spage><epage>112</epage><pages>105-112</pages><issn>0041-4301</issn><abstract>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.</abstract><cop>Turkey</cop><pub>Hacettepe University Faculty of Medicine</pub><pmid>22734295</pmid><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Anti-Bacterial Agents - therapeutic use Child Child, Preschool Female Fever - microbiology Humans Lymphatic Diseases - microbiology Male Pharyngitis - microbiology Retrospective Studies Tonsillitis - microbiology Tularemia - diagnosis Tularemia - drug therapy Turkey |
| title | Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases |
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