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Internal Medicine

Tularemia “Rabbit fever”

Tularemia, also known as rabbit fever, is an infectious disease caused by the bacterium Francisella tularensis.


Aetiology

  • Typically spread by ticks, deer flies, contact with infected animals

Clinical features

  • Skin lesions (6 characteristic clinical variants):
    • Ulceroglandular (M/C, 75%)
    • Glandular
    • Oropharyngeal
    • Pneumonic
    • Oculoglandular
    • Typhoidal
  • Fever, lethargy, loss of appetite, lymphadenopathy (may suppurate, mimicking bubonic plague), signs of sepsis, and possibly death
640px-tularemia_lesion
A tularemia lesion on the back of the right hand | Public Domain, https://commons.wikimedia.org/w/index.php?curid=2555025

Diagnosis

Investigations

Bacterial culture

  • Buffered charcoal yeast extract agar (special media)
542px-chocolate_agar_1
Chocolate agar culture showing Francisella tularensis colonies | CDC/ Megan Mathias and J. Todd Parker – http://phil.cdc.gov/phil/details.asp, Public Domain, https://commons.wikimedia.org/w/index.php?curid=8471912

Management

Antibiotics:

  • Streptomycin or gentamicin

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