TULAREMIA “RABBIT HUNTER’S DISEASE”
INITIALLY DESCRIBED IN TULARY COUNTY IN CALIFORNIA
FRANCISELLA TULARENSIS——”WAS A RABBIT HUNTER”
G- PLEOMORPHIC ROD
VECTORS ARE RABBITS,DEER, TICKS, AND DEER FLIES
SPREAD BY DIRECT CONTACT—
1) INOCULATION THROUGH THE SKIN—
PRE-AURICULAR LAD, PHOTOPHOBIA, IPSILAT CERVICAL LAD—USUALLY MANIFESTS AS AN ERYTHEMATOUS PAPULE OVER OR NEAR TO THE PAROTID, POSSIBLE VISUAL CHANGES
2) INGESTION—–GETS IN THROUGH THE GI TRACT
POSSIBLE EXUDATIVE PHARYNGITIS, DIFFUSE LAD—-CHRONIC GRANULOMATOUS Dz
SEEN OFTEN IN MID MISSOURI
Dx: SERUM AGGLUTINATION TEST
MAY I&D/Bx—MAY HELP Dx
CHECK A CXR!
Rx: CLASSICALLY STREPTO- OR GENT = 1ST LINE, TETRACYCLINE OR CHLORAMPHENICOL = 2ND LINE
RECENTLY CIPRO HAS BEEN ADVOCATED—SEEMS TO WORK
MAY I&D LATER IN THE COURSE