Evaluation of tularemia cases focusing on the oculoglandular form

  • Sebnem Eren Gok Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Aysel Kocagul Celikbas Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Nurcan Baykam Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Ayse Atay Buyukdemirci Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Mustafa Necati Eroglu Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Ozlem Evren Kemer Ankara Numune Training and Research Hospital, Ankara, Turkey
  • Basak Dokuzoguz Ankara Numune Training and Research Hospital, Ankara, Turkey
Keywords: tularemia, ocular involvement, tularemia outbreak

Abstract

Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. The oculoglandular form is one of the rarest forms. In this study, evaluated tularemia patients, focusing on the ocular form and the efficacy of early antibiotic therapy.

Methodology: During a tularemia outbreak, the epidemiological and clinical findings, laboratory assays, and drugs used for the treatment of 48 patients were recorded prospectively. The diagnosis of tularemia was confirmed with microagglutination test (MAT) as well as clinical findings.

Results: The mean age of the subject was 48.6 years; 23 (47.9%) of them were female. Thirty-six (81.25%) patients had clinical presentation compatible with oropharyngeal tularemia, seven (14.58%) with oculoglandular tularemia, and two (4.1%) with ulceroglandular tularemia. The most common symptoms were fever (91.6%) and sore throat (81.2%), and the most common findings were lymphadenopathy (91.6%) and tonsillopharyngitis (81.2%). In the oculoglandular form, fever, lymphadenopathy, periorbital edema, conjunctival injection, and chemosis were found. The most distinctive ophthalmic feature was follicular conjunctivitis and conjunctival epithelial defects. Forty-five cases had positive serological results with MAT. All the patients were treated with antibiotics considered effective against F. tularensis, and topical antimicrobial treatment was given to the patients with oculoglandular tularemia. Twenty-six (54.16%) patients, who were admitted within three weeks of the onset of symptoms, recovered without sequel.

Conclusions: During tularemia outbreaks, ocular involvement should be considered carefully. The early administration of appropriate treatment will be more effective in resolving the infection and preventing complications. Along with systemic antibiotic therapy, topical treatment will help recovery.

Author Biographies

Aysel Kocagul Celikbas, Ankara Numune Training and Research Hospital, Ankara, Turkey
Infectious Diseases and Clinical Microbiology Department
Nurcan Baykam, Ankara Numune Training and Research Hospital, Ankara, Turkey
Infectious Diseases and Clinical Microbiology Department
Ayse Atay Buyukdemirci, Ankara Numune Training and Research Hospital, Ankara, Turkey
Infectious Diseases and Clinical Microbiology Department
Mustafa Necati Eroglu, Ankara Numune Training and Research Hospital, Ankara, Turkey
Infectious Diseases and Clinical Microbiology Department
Ozlem Evren Kemer, Ankara Numune Training and Research Hospital, Ankara, Turkey
Ophthalmology Department
Basak Dokuzoguz, Ankara Numune Training and Research Hospital, Ankara, Turkey
Infectious Diseases and Clinical Microbiology Department
Published
2014-10-15
How to Cite
1.
Eren Gok S, Kocagul Celikbas A, Baykam N, Atay Buyukdemirci A, Eroglu MN, Evren Kemer O, Dokuzoguz B (2014) Evaluation of tularemia cases focusing on the oculoglandular form. J Infect Dev Ctries 8:1277-1284. doi: 10.3855/jidc.3996
Section
Original Articles