Tularemia in Children: Evaluation of 22 Cases
Yıl: 2022 Cilt: 16 Sayı: 1 Sayfa Aralığı: 41 - 46 Metin Dili: İngilizce DOI: 10.5578/ced.20229906 İndeks Tarihi: 24-05-2023
Tularemia in Children: Evaluation of 22 Cases
Öz: Objective: Tularemia is a highly contagious bacterial zoonotic disease de riving from gram-negative Francisella tularensis. The disease is difficult for clinicians, and due to its rarity, a high level of suspicion is required for di agnosis. The purpose of the present study was to retrospectively examine the clinical characteristics, laboratory findings, and responses to treatment of pediatric tularemia cases treated in our clinic. Material and Methods: Pediatric tularemia cases were included in this retrospective study. The medical records of patients with confirmed diag noses were examined, and demographic characteristics such as age and gender, presentation symptoms, and risky contact status were recorded. Factors such as living in rural areas, working in agriculture and animal husbandry, similar disease among friends and family, and drinking water sources were examined. Patients’ physical and laboratory findings, and medical and surgical treatment results were recorded. Results: Twenty-two pediatric cases were included in the study, 15 (68.2%) boys and seven (31.8%) girls. The patients were aged mean 12 ± 2.8 (min max; 3-15 years), and 15 (68.2%) were diagnosed in the fall. The mean time from onset of symptoms to presentation to our hospital was 31.8 ± 20.8 days (min-max; 7-90 days). The most common presentation symptoms were fatigue (54.5%), fever (45.5%), sore throat (%45.5), lack of appetite (40.9%), and abdominal pain-diarrhea (31.8%). Cervical lymphadenopathy (LAP) was determined in all patients at physical examination. Surgical treat ment was applied to 18 (81.8%) patients who did not respond to medical treatment [abscess drainage to 14 (63.6%) and LAP excision to four (18.2%)]. Conclusion: Tularemia must be considered in terms of early diagnosis and treatment in children presenting with cervical LAP in endemic regions and not responding to β-lactam and/or macrolide group antibiotics.
Anahtar Kelime: Çocuklarda Tularemi: 22 Vakanın Değerlendirilmesi
Öz: Giriş: Tularemi, gram-negatif Francisella tularensis’ten kaynaklanan ol dukça bulaşıcı bakteriyel zoonotik bir hastalıktır. Hastalık klinisyenler için zordur ve nadir görülmesi nedeniyle tanı için yüksek düzeyde şüphe gerekir. Bu çalışmanın amacı, kliniğimizde tedavi edilen pediatrik tula remi olgularının klinik özelliklerini, laboratuvar bulgularını ve tedaviye yanıtlarını geriye dönük olarak incelemektir. Gereç ve Yöntemler: Bu retrospektif çalışmaya pediatrik tularemi olgu ları dahil edildi. Tanısı doğrulanan hastaların tıbbi kayıtları incelendi ve yaş, cinsiyet gibi demografik özellikleri, başvuru şikayetleri, riskli temas durumu kaydedildi. Kırsal bölgede yaşam, tarım ve hayvancılıkla uğraş ma, aile ve çevrede benzer hastalık durumu, içme suyu kaynağı incelen di. Hastaların fizik muayene ve laboratuvar bulguları, medikal ve cerrahi tedavi sonuçları kaydedildi. Bulgular: Çalışmaya 15 erkek (%68.2) ve yedi kız (%31.8) olmak üzere 22 pediatrik vaka dahil edildi. Hastaların yaş ortalaması 12 ± 2.8 (min-maks; 3-15 yıl)’di ve 15 (%68.2) hasta sonbaharda teşhis edildi. Semptomların başlangıcından hastanemize başvuruya kadar geçen süre ortalama 31.8 ± 20.8 gün (min-maks; 7-90 gün) idi. En sık başvuru semptomları halsizlik (%54.5), ateş (%45.5), boğaz ağrısı (%45.5), iştahsızlık (%40.9) ve karın ağrı sı-ishal (%31.8)’di. Fizik muayenede tüm hastalarda servikal lenfadenopati (LAP) belirlendi. Medikal tedaviye yanıt vermeyen 18 (%81.8) hastaya cer rahi tedavi uygulandı (14 [%63.6]’üne apse drenajı ve 4 [%18.2]’üne LAP eksizyonu). Sonuç: Tularemi, endemik bölgelerde servikal LAP ile başvuran ve β-lak tam ve/veya makrolid grubu antibiyotiklere yanıt vermeyen çocuklarda erken tanı ve tedavi açısından düşünülmelidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Snowden J, Stovall S. Tularemia: retrospective review of 10 years’ expe rience in Arkansas. Clin Pediatr (Phila) 2011;50:64-8. [CrossRef]
- 2. Kaya A, Deveci K, Uysal IO, Guven AS, Demir M, Uysal EB, et al. Tularemia in children: evaluation of clinical, laboratory and therapeutic features of 27 tularemia cases. Turk J Pediatr 2012;54:105-12.
- 3. Imbimbo C, Karrer U, Wittwer M, Buettcher M. Tularemia in Children and Adolescents. Pediatr Infect Dis J 2020;39:435-8. [CrossRef]
- 4. Celebi S, Hacimustafaoglu M, Gedikoglu S. Tularemia in Children. Indi an J Pediatr 2008;75:1129-32. [CrossRef]
- 5. Tezer H, Ozkaya-Parlakay A, Aykan H, Erkocoglu M, Gulhan B, Demir A, et al. Tularemia in children, Turkey, September 2009-November 2012. Emerg Infect Dis 2015;21:1-7. [CrossRef]
- 6. Kara A. Tularemi. Katkı Pediatri Dergisi 2002;23:45-54.
- 7. World Health Organization. WHO guidelines on tularemia. Available from: http://whqlibdoc.who.int/publications/2007/9789241547376_ eng.pdf (Accessed date: 22 Jul 2013).
- 8. Kılıc S. A general overview of Francisella tularensis and the epide¬miol ogy of tularemia in Turkey [in Turkish]. Flora 2010;15:37-58.
- 9. Akalın H. Türkiye‘de Tularemi Salgınları. Klinik Gelişim 2010;23:36-9.
- 10. Ceylan O, Kose M, Ozturk MK. The evaluation of pediatric patients with tularemia. İzmir Dr. Behçet Uz Çocuk Hast Dergisi 2012;2:131-6 [CrossRef]
- 11. Celebi S, Koyuncu E, Bozdemir SE, Cetin BS, Hacımustafaoglu MK. Çocuklarda tularemi: tularemili 15 olgunun klinik, laboratuvar ve teda vi sonuçlarının değerlendirilmesi. Güncel Pediatri 2013;11:57-62.
- 12. Cross JT, Schutze GE, Jacobs RF. Treatment of tularemia with gentami cin in pediatric patients. Pediatr Infect Dis J 1995;14:151-2. [CrossRef]
- 13. Syrjälä H, Karvonen J, Salminen A. Skin manifestations of tularemia: a study of 88 cases in northern Finland during 16 years (1967-1983). Acta Derm Venereol 1984;64:513-6.
- 14. Penn RL. Francisella Tularensis (Tularemia). In: Mandell GL, Douglas RG, Bennett JE (eds). Mandell, Dougles, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. New York: Churchill Livingstone, 2010:2927-37. [CrossRef]
- 15. Oz F, Eksioglu A, Tanır G, Bayhan G, Metin O, Aydın Teke T. Evaluation of clinical and sonographic features in 55 children with tularemia. Vector Borne Zoonotic Dis 2014;14:571-5. [CrossRef]
- 16. Jounio U, Renko M, Uhari M. An outbreak of holarctica-type tularemia in pediatric patients. Pediatr Infect Dis J 2010;29:160-2. [CrossRef]
- 17. Onen S, Paksoy D, Bilge YD. Çocukluk çağında tularemi olguları. J Pedi atr Inf 2012;6:94-100. [CrossRef]
- 18. Tunga U, Bodrumlu E, Acikgoz A, Acikgoz G. A case of tularemia pre senting as a dental abscess: case report. Oral Surg Med Oral Pathol Oral Radiol Endod 2007;103:33-5. [CrossRef]
- 19. Penn FL. Francisella tularensis (Tularemia). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 6th ed. Phila delphia: Churchill Livingstone, 2005:2674-85.
- 20. Atmaca S, Leblebicioğlu H, Unalan R, Tekat A, Sesen T, Koyuncu M, et al. Samsun ve çevresinde görülen tularemi olguları. KBB-Forum 2005;4:171-2.
APA | KARS A, Esmeray Şenol P, Köyceğiz S (2022). Tularemia in Children: Evaluation of 22 Cases. , 41 - 46. 10.5578/ced.20229906 |
Chicago | KARS AYHAN,Esmeray Şenol Pelin,Köyceğiz Sinan Tularemia in Children: Evaluation of 22 Cases. (2022): 41 - 46. 10.5578/ced.20229906 |
MLA | KARS AYHAN,Esmeray Şenol Pelin,Köyceğiz Sinan Tularemia in Children: Evaluation of 22 Cases. , 2022, ss.41 - 46. 10.5578/ced.20229906 |
AMA | KARS A,Esmeray Şenol P,Köyceğiz S Tularemia in Children: Evaluation of 22 Cases. . 2022; 41 - 46. 10.5578/ced.20229906 |
Vancouver | KARS A,Esmeray Şenol P,Köyceğiz S Tularemia in Children: Evaluation of 22 Cases. . 2022; 41 - 46. 10.5578/ced.20229906 |
IEEE | KARS A,Esmeray Şenol P,Köyceğiz S "Tularemia in Children: Evaluation of 22 Cases." , ss.41 - 46, 2022. 10.5578/ced.20229906 |
ISNAD | KARS, AYHAN vd. "Tularemia in Children: Evaluation of 22 Cases". (2022), 41-46. https://doi.org/10.5578/ced.20229906 |
APA | KARS A, Esmeray Şenol P, Köyceğiz S (2022). Tularemia in Children: Evaluation of 22 Cases. Çocuk Enfeksiyon Dergisi, 16(1), 41 - 46. 10.5578/ced.20229906 |
Chicago | KARS AYHAN,Esmeray Şenol Pelin,Köyceğiz Sinan Tularemia in Children: Evaluation of 22 Cases. Çocuk Enfeksiyon Dergisi 16, no.1 (2022): 41 - 46. 10.5578/ced.20229906 |
MLA | KARS AYHAN,Esmeray Şenol Pelin,Köyceğiz Sinan Tularemia in Children: Evaluation of 22 Cases. Çocuk Enfeksiyon Dergisi, vol.16, no.1, 2022, ss.41 - 46. 10.5578/ced.20229906 |
AMA | KARS A,Esmeray Şenol P,Köyceğiz S Tularemia in Children: Evaluation of 22 Cases. Çocuk Enfeksiyon Dergisi. 2022; 16(1): 41 - 46. 10.5578/ced.20229906 |
Vancouver | KARS A,Esmeray Şenol P,Köyceğiz S Tularemia in Children: Evaluation of 22 Cases. Çocuk Enfeksiyon Dergisi. 2022; 16(1): 41 - 46. 10.5578/ced.20229906 |
IEEE | KARS A,Esmeray Şenol P,Köyceğiz S "Tularemia in Children: Evaluation of 22 Cases." Çocuk Enfeksiyon Dergisi, 16, ss.41 - 46, 2022. 10.5578/ced.20229906 |
ISNAD | KARS, AYHAN vd. "Tularemia in Children: Evaluation of 22 Cases". Çocuk Enfeksiyon Dergisi 16/1 (2022), 41-46. https://doi.org/10.5578/ced.20229906 |