Odegaard Karah, Boersma Beth, Keegan James
University of South Dakota Sanford School of Medicine.
Department of Infection Control, Rapid City Regional Hospital, Rapid City, South Dakota.
S D Med. 2017 May;70(5):207-209.
Francisella tularensis is a gram-negative coccobacillus that causes a condition commonly referred to as tularemia. There has been a dramatic increase in tularemia cases reported in South Dakota, many of which were challenging to diagnose due to atypical clinical manifestations. We describe an interesting case of pneumonic tularemia and summarize six similar cases, several of which presented with lung nodules suggestive of malignancy. According to the literature, this is only the third outbreak of pneumonic tularemia reported in the U.S. We believe it is important for clinicians to be aware of the increased incidence of tularemia in the area and to be vigilant in the diagnosis and management of these atypically presenting cases.
土拉弗朗西斯菌是一种革兰氏阴性球杆菌，可引发一种通常被称为兔热病的疾病。南达科他州报告的兔热病病例急剧增加，其中许多病例由于临床表现不典型而难以诊断。我们描述了一例有趣的肺型兔热病病例，并总结了六例类似病例，其中几例表现为提示恶性肿瘤的肺结节。根据文献记载，这是美国报告的第三次肺型兔热病疫情。我们认为，临床医生了解该地区兔热病发病率的上升情况，并对这些表现不典型的病例保持诊断和管理的警惕性非常重要。
