PEDIATRICS Vol. 6 No. 1 July 1950, pp. 113-123
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by LEVY, H. B.
Right arrow Articles by WILKINSON, J. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by LEVY, H. B.
Right arrow Articles by WILKINSON, J. D.

TULAREMIA AS A PEDIATRIC PROBLEM

HAROLD B. LEVY M.D.1, CLARENCE H. WEBB M.D., F.A.A.P.1, and JACQUES D. WILKINSON M.D.1

1 The Pediatric Service, Shreveport Charity Hospital, Shreveport, La.

The results obtained, it would appear that the lack of any pathognomonic clinical feature, tardy appearance of specific agglutinins, and variations from the typical adult course render imperative a high index of suspicion if an early diagnosis of tularemia is to be made in a child. Careful questioning concerning possible ingestion of infected meats, animal contact or tick bite must be stressed. Involvement of siblings may be a strong point in favor of ingestional tularemia.

Painstaking search for a local lesion should be made in every case with unexplained adenitis or appearance of sepsis; the frequency of pharyngo-tonsillar involvement must be appreciated. Usual laboratory aids may be of little value in early diagnosis in the average hospital or office at the present time. Early appearance of the heterophile cross-agglutination reaction may alert the observer to the possibility of tularemic infection.

A severely ill patient, for whom a definitive diagnosis cannot be reached, failing to respond to therapy for other suspected illnesses, and in whom any of the factors just mentioned prevail, should receive the benefit of a therapeutic test with streptomycin. Favorable response and survival, as is true of effective antibiotic therapy for other acute illnesses, may permit of later retrospective diagnosis in some whose illnesses or deaths would otherwise have remained unexplained.

Submitted on November 18, 1949




This article has been cited by other articles:


Home page
 CLIN PEDIATRHome page
D. P. Speert, W. J. Britt, and E. L. Kaplan
Tick-Borne Tularemia Presenting as Ulcerative Lymphadenitis
Clinical Pediatrics, April 1, 1979; 18(4): 239 - 241.
[PDF]