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Internal Medicine

Tularemia “Rabbit fever”

In 2015, more than 100 cases of rabbit fever were reported in the U.S. These animals in the wild are known to carry the bacteria that causes the illness. | Reuters/Mark Blinch

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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