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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 6. Diseases Caused by Gram-Negative Bacteria > |
Chapter 158. Tularemia
Sections: Tularemia: Introduction, Further Readings.
Topics Discussed: francisella tularensis; tularemia.
Excerpt:"Tularemia is a zoonosis caused by Francisella tularensis. Humans of any age, sex, or race are universally susceptible to this systemic infection. Tularemia is primarily a disease of wild animals and persists in contaminated environments, ectoparasites, and animal carriers. Human infection is incidental and usually results from interaction with biting or blood-sucking insects, contact with wild or domestic animals, ingestion of contaminated water or food, or inhalation of infective aerosols. The illness is characterized by various clinical syndromes, the most common of which consists of an ulcerative lesion at the site of inoculation, with regional lymphadenopathy and lymphadenitis. Systemic manifestations, including pneumonia, typhoidal tularemia, meningitis, and fever without localizing findings, pose a greater diagnostic challenge.Tularemia is common in Arkansas, Oklahoma, Missouri, and South Dakota; these states account for more than half of all reported cases in the United States. Small outbreaks in higher-risk populations (e.g., professional landscapers cutting up brush, mowing, and using a leaf blower) have been reported from the island of Martha's Vineyard in Massachusetts. Although the irregular distribution of cases of tularemia makes worldwide estimates..."
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