Tularemia ulceroglandular

Signs and Symptoms Ulceroglandular tularemia presents a local ulcer and regional lymphadenopathy (any disease process affecting a lymph node or lymph nodes), fever, chills, headache, and malaise. Typhoidal or septicemic tularemia presents fever, headache, malaise, substernal discomfort, prostration, weight loss and a non-productive cough. 

Ulceroglandular tularemia, glandular tularemia, typhoidal tularemia, oculoglandular tularemia, oropharyngeal tularemia, and pneumonic tularemia... 

Ulceroglandular tularemia is the most common form. It comprises 70 to 75% of all cases. Pneumonic tularemia is the next most common (8 to 13%), followed by glandular tularemia (5 to 12%). The other forms are less common. Typhoidal tularemia has the highest mortality rate and as a result is the most likely to be used by terrorists. Exposure causes acute onset of fever, chills, headache, vomiting, and diarrhea. Skin lesions and swollen lymph nodes are not usual. This is a systemic disease and is the only form of tularemia in which diarrhea is usually seen.3... 

Tularemia Although streptomycin is preferable, tetracyclines also are effective for both ulceroglandular and typhoidal types of tularemia. 

Tularemia can be divided into the ulceroglan-dular (75% of patients) and the typhoidal (25% of patients) forms, based on the clinical signs. Patients with ulceroglandular tularemia have lesions on the skin or mucous membranes (including the conjunctiva), lymph nodes larger than 1 cm in diameter, or both. Patients with typhoidal tularemia, on the... 

Patients with tularemia who do not receive appropriate antibiotic treatment may have a prolonged illness characterized by malaise, weakness, weight loss, and other symptoms that last for months.22 82 84 85 Before the availability of effective antibiotics, ulceroglandular and typhoidal tularemia had mortalities of approximately 4% and 35%, respectively.44 57 With appropriate treatment, tularemia has an overall mortality of approximately 1% to 2.5%.13,86,87... 

Evidence based on an analysis of laboratory-acquired infections99 indicates that immunization with the live, attenuated LVS vaccine prevents the typhoidal and ameliorates the ulceroglandular forms of tularemia. The LVS vaccine is currently available as an Investigational New Drug from the U.S. Army Medical Research and Materiel Command, Fort Detrick, Frederick, Maryland 21702-5011. 

Ulceroglandular Referring to the form of tularemia caused by entry of Francisella tularensis through the skin and characterized by ulcers on the skin and enlarged regional lymph nodes. 

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