PEDIATRICS Vol. 76 No. 5 November 1985, pp. 818-822
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Tularemia in Adults and Children: A Changing Presentation

Richard F. Jacobs MD1, Yoland M. Condrey MD1, and Terry Yamauchi MD1

1 From the Department of Pediatrics, Pediatric Infectious Disease, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock

Tularemia, a febrile zoonosis with six clinical types, recently has been shown to occur at an increased incidence in children compared with previous reports. Ulceroglandular and glandular tularemia are still the most common types, but pneumonic tularemia has increased in incidence. However, with these changes, an overall decline in mortality has been observed. Children exhibit fever, pharyngitis, hepatosplenomegaly, and constitutional symptoms more often than affected adults. The complication of late lymph node suppuration is found in half of the tularemia patients with lymphadenopathy. A high index of clinical suspicion and a good medical history and physical examination confirmed by specific serologic studies are the critical factors in the successful diagnosis of tularemia in children.

Key Words: tularemia • zoonosis • lymphadenopathy

Submitted on November 2, 1984
Accepted on December 12, 1984




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