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Tularemia (Francisella tularensis)
1999 Case Definition
Clinical description
An illness characterized by several distinct forms,
including the following:
- Ulceroglandular: cutaneous ulcer with
regional lymphadenopathy
- Glandular: regional lymphadenopathy with
no ulcer
- Oculoglandular: conjunctivitis with preauricular
lymphadenopathy
- Oropharyngeal: stomatitis or pharyngitis
or tonsillitis and cervical lymphadenopathy
- Intestinal: intestinal pain, vomiting,
and diarrhea
- Pneumonic: primary pleuropulmonary disease
- Typhoidal: febrile illness without early
localizing signs and symptoms
Clinical diagnosis is supported by evidence or
history of a tick or deerfly bite, exposure to tissues of a mammalian
host of Francisella tularensis, or exposure to potentially
contaminated water.
Laboratory criteria for diagnosis
Presumptive
- Elevated serum antibody titer(s) to F. tularensis antigen
(without documented fourfold or greater change) in a patient
with no history of tularemia vaccination or
- Detection of F. tularensis in a clinical
specimen by fluorescent assay
Confirmatory
- Isolation of F. tularensis in a clinical
specimen or
- Fourfold or greater change in serum antibody
titer to F. tularensis antigen
Case classification
Probable: a clinically
compatible case with laboratory results indicative of presumptive
infection
Confirmed: a clinically compatible case
with confirmatory laboratory results
See also:
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