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Angina in tularemia
Last reviewed: 07.07.2025
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Tularemia is an acute infectious disease with natural focality, characterized by fever and damage to the lymph nodes.
In 1910, American bacteriologist G. McCoy discovered a disease in ground squirrels that was similar to plague in its pathological changes. In 1911, G. McCoy and Ch. Chapin isolated a small bacterium from ground squirrels suffering from this disease and named it strong. tularense after Tulare County, California (USA), where the sick animals were found. In 1921, American physician E. Francis named this disease tularemia, using the species name of the pathogen. In the former USSR, the tularemia pathogen was isolated in 1926 by S. V. Suvorov et al. during an examination of sick people in the Volga Delta near Astrakhan.
[ Epidemiology of tularemia
The source of tularemia are sick animals. Natural foci are maintained by small mammals (water and common voles, house mice, muskrats, hares, hamsters, etc.). Sick and dead animals and their excrements contain a large number of pathogens. Humans are highly susceptible to this disease, and are infected by contact, aspiration, alimentary, and transmission (insect bites). In some cases, the disease is professional in nature (hunters, butchers, furriers, agricultural workers, etc.). Sick people are not contagious.
Immunity in tularemia
Those who have recovered from tularemia develop long-term immunity. When a live tularemia vaccine is administered, artificial immunity develops that lasts for 5 years or more.
The diagnosis is based on epidemiological, clinical and laboratory data. To confirm the diagnosis, an intradermal allergy test with the tularemia antigen tularin is used.
Differential diagnostics are carried out primarily with the bubonic form of plague in the territory of natural foci of this infection (India, Pakistan, Mongolia, Burma, Indochina, Central Asia, Transbaikalia; in Europe - the Volga-Ural focus and the North-West Caspian region). In plague, the toxic syndrome is more pronounced, characterized by severe pain and the absence of clear contours of the bubo.
Symptoms of sore throat in tularemia
The causative agent of tularemia enters the human body through the skin, mucous membranes of the eyes, respiratory tract, and gastrointestinal tract. The entry gate determines the clinical form of the disease. At the site of penetration of the pathogen during the transmission route of infection, a primary affect often develops - a limited inflammatory process with primary regional lymphadenitis (primary bubo).
The pathogen and its toxins penetrate into the blood, which leads to the generalization of the process, damage to distant lymph nodes (secondary buboes) and various organs.
The angina-bubonic form occurs when drinking water from an infected body of water or swimming in it. Patients complain of a sore throat, difficulty swallowing, and a tickling sensation. The tonsils are enlarged, often on one side, covered with a grayish-white coating. Later, deep, slowly healing ulcers form on them, resembling gangrenous tonsillitis in appearance.
Similar changes can be observed on the soft palate, oral mucosa and lower lip. The ulcer bottom is covered with a diphtheroid coating of a yellowish-gray color, not fused with the underlying tissue. The angina-bubonic form of tularemia occurs on the 3rd-4th day after the appearance of lymphadenitis and can be mistaken for Simanovsky-Plaut-Vincent angina or diphtheria of the palatine tonsils. The duration of tularemia angina is from 8 to 24 days. Often, the primary affect that occurs on the tonsil remains unnoticed, and the disease progresses in the form of a pronounced bubonic form, in which the inflammation covers almost all the lymph nodes of the neck, often developing into abscesses and phlegmons of this area. Other clinical forms of tularemia are not considered in this manual, since they are within the competence of infectious disease specialists.
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Treatment of sore throat in tularemia
Treatment is carried out in a hospital for infectious patients. Antibiotics, detoxification solutions (water-electrolyte, glucose, hemodez, polyglucin, etc.), antihistamines (diphenhydramine, pipolfen, suprastin, etc.), vitamins C and group B are prescribed. Dry heat is applied to the bubo, and if it is suppurating (fluctuation symptom) - wide opening and removal of detritus with subsequent drainage with tampons with a hypertonic solution and their change 3 times a day.
In the angina-bubonic form - gargle with warm antiseptic solutions, decoctions of medicinal herbs, drink plenty of fluids. In case of eye damage - sodium sulfacyl, antibiotics, ointments.
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Prevention of tularemia
Control of rodents and blood-sucking insects, compliance with anti-infection measures by workers in relevant professions, use of personal protective equipment, vaccination with tularemia live dry vaccine.
Prognosis for tularemia
The prognosis is favorable. In pulmonary and abdominal forms - serious.