Özden Kemalettin, Özden Ayşe, Albayrak Ayşe, Özkurt Zülal, Döneray Hakan, Parlak Mehmet
Atatürk University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey.
Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey.
Mikrobiyol Bul. 2018 Jan;52(1):108-110. doi: 10.5578/mb.57283.
Tularemia is a zoonotic infectious disease caused by Francisella tularensis. Tularemia is endemic in the northern hemisphere and is usually seen in North America, Europe and Asia. Although the ulceroglandular tularemia is the most common form in these regions, the oropharyngeal form is more prevalent in Eastern Europe, including Turkey. The disease has importance in Turkey due to its wide geographic distribution and periodic outbreaks. The aim of this study was to determine the demographic, clinical and epidemiological characteristics of oropharyngeal tularemia patients. The demographic, clinical, epidemiological and laboratory findings of 26 tularemia patients admitted to our hospital from Erzurum and 5 neighbour provinces were analyzed retrospectively. Francisella tularensis microagglutination test (MAT) was performed for all patients whose clinical symptoms were consistent with tularemia and MAT titers ≥ 1/160 were considered positive. Twenty-six oropharyngeal tularemia patients (13 males and 13 females) were included in the study. All of the patients had cervical lymphadenopathy (LAP) at least one month period. Twenty (76.9%) of the patients included in the study were living in rural areas, and 17 (65.4%) were dealing with livestock. It was determined that 9 (34.6%) of the patients used water from municipal water supply, 9 (34.6%) of the patients used water from natural water supply and 8 (30.8%) of the patients used both of the water supplies. The most common symptoms among the patients in the study were fever in 23 (88.5%) patients, sore throat in 24 (92.3%) patients, and cervical LAP in all of the patients. Thirteen (50%) of the patients were treated with streptomycin, 7 (26.9%) with doxycycline and 6 (23.1%) with gentamicin. This is the first study showing that tularemia is present in Erzincan, Ağrı, Iğdır as well as Erzurum provinces, and it provides that the incidence has increased in this region. Tularemia diagnosis is generally underestimated due to the lack of specific symptoms. Therefore, tularemia should also be considered in patients who have complaints of sore throat and cervical LAP in non-endemic regions.
兔热病是一种由土拉弗朗西斯菌引起的人畜共患传染病。兔热病在北半球呈地方性流行，常见于北美、欧洲和亚洲。虽然溃疡腺型兔热病在这些地区最为常见，但口咽型在包括土耳其在内的东欧更为普遍。由于其广泛的地理分布和周期性爆发，该病在土耳其具有重要意义。本研究的目的是确定口咽型兔热病患者的人口统计学、临床和流行病学特征。回顾性分析了从埃尔祖鲁姆及5个邻省收治到我院的26例兔热病患者的人口统计学、临床、流行病学和实验室检查结果。对所有临床症状符合兔热病的患者进行土拉弗朗西斯菌微量凝集试验（MAT），MAT滴度≥1/160被视为阳性。26例口咽型兔热病患者（13例男性和13例女性）纳入研究。所有患者至少在一个月内有颈部淋巴结病（LAP）。纳入研究的患者中有20例（76.9%）生活在农村地区，17例（65.4%）从事畜牧业。确定9例（34.6%）患者使用市政供水，9例（34.6%）患者使用天然供水，8例（30.8%）患者同时使用这两种供水。研究中患者最常见的症状是23例（88.5%）发热、24例（92.3%）咽痛以及所有患者均有颈部LAP。13例（50%）患者接受链霉素治疗，7例（26.9%）接受多西环素治疗，6例（23.1%）接受庆大霉素治疗。这是第一项表明兔热病存在于埃尔津詹、阿格里、伊兹密尔以及埃尔祖鲁姆省的研究，并且表明该地区发病率有所上升。由于缺乏特异性症状，兔热病的诊断通常被低估。因此，在非流行地区有咽痛和颈部LAP主诉的患者中也应考虑兔热病。
