Koç Sema, Duygu Fazilet, Söğüt Erkan, Gürbüzler Levent, Eyibilen Ahmet, Aladağ Ibrahim
Department of Otolaryngology, Medicine Faculty of Gaziosmanpaşa University, Tokat, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2012 Jan-Feb;22(1):26-31. doi: 10.5606/kbbihtisas.2012.005.
This study aims to define demographic characteristics and clinical and laboratory findings of the patients with tularemia and to assess the treatment outcomes.
A total of 58 consecutive patients (26 males, 32 females; mean age 37±22 years; range 6 to 80 years) with tularemia were retrospectively analyzed in this study. Demographic characteristics, laboratory findings, physical examination findings and treatment outcomes were recorded.
Forty patients (86.2%) had glandular tularemia; seven (12.1%) had oropharyngeal tularemia, and one (1.7%) patient had oculoglandular tularemia. The most common symptoms were swollen neck lymph nodes high fever and sore throat. Fifty seven patients (98.2%) had swollen neck lymph nodes; 39 (67.2%) patients had high fever (67.2%) and 36 (62.1%) patients had sore throat. Complete recovery was obtained in 45 patients (77.6%), while 13 (22.4%) were unresponsive to the treatment. The most frequent laboratory findings were high level of C-reactive protein (CRP) and increased erythrocyte sedimentation rate (ESR). Mean leukocyte counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine levels were within normal range in all patients.
Tularemia should be differentiated from upper respiratory tract infections and cervical lymphadenopathy. The most commonly used hematological and biochemical assays do not provide significant benefits for the diagnosis of tularemia. However, increased level of ESR and CRP at one month may support the diagnosis. Early diagnosis and appropriate treatment may prevent therapeutic failure.
本研究旨在明确兔热病患者的人口统计学特征、临床及实验室检查结果，并评估治疗效果。
本研究对58例连续性兔热病患者（26例男性，32例女性；平均年龄37±22岁；年龄范围6至80岁）进行了回顾性分析。记录了人口统计学特征、实验室检查结果、体格检查结果及治疗效果。
40例患者（86.2%）为腺型兔热病；7例（12.1%）为口咽型兔热病，1例（1.7%）为眼腺型兔热病。最常见的症状为颈部淋巴结肿大、高热和咽痛。57例患者（98.2%）有颈部淋巴结肿大；39例（67.2%）患者有高热，36例（62.1%）患者有咽痛。45例患者（77.6%）完全康复，13例（22.4%）对治疗无反应。最常见的实验室检查结果为C反应蛋白（CRP）水平升高和红细胞沉降率（ESR）加快。所有患者的平均白细胞计数、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、尿素和肌酐水平均在正常范围内。
兔热病应与上呼吸道感染和颈部淋巴结病相鉴别。最常用的血液学和生化检测对兔热病的诊断并无显著帮助。然而，治疗1个月时ESR和CRP水平升高可能支持诊断。早期诊断和恰当治疗可预防治疗失败。
