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Tularemia (Francisella tularensis)
1990 Case Definition
Clinical description
An illness characterized by several distinct forms,
including:
- Ulceroglandular: cutaneous ulcer with
regional lymphadenopathy
- Glandular: regional lymphadenopathy with
no ulcer
- Oculoglandular: conjunctivitis with preauricular
lymphadenopathy
- Intestinal: pharyngitis, 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
- Isolation of F. tularensis from a clinical
specimen, or
- Demonstration of F. tularensis in a
clinical specimen by immunofluorescence, or
- Fourfold or greater rise in agglutination titer
between acute- and convalescent-phase serum specimens obtained
greater than or equal to 2 weeks apart, analyzed at the same
time, and in the same laboratory
Case classification
Probable: a clinically
compatible case with supportive serologic results (tularemia agglutination
titer of greater than or equal to 160 in one or more serum specimens
obtained after onset of symptoms)
Confirmed: a case that is laboratory confirmed
See also:
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