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Diagnosis of tularemia
Last reviewed: 06.07.2025
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Tularemia is diagnosed based on a combination of clinical, epidemiological and laboratory data. Of the epidemiological data, contact with animals in the natural focus of infection is of the greatest importance.
For laboratory confirmation, RA and RPGA are used. Specific antibodies begin to be detected at the end of the 1st or the beginning of the 2nd week from the onset of the disease and reach a maximum at the 4th-6th week. The diagnostic titer is 1:100 and higher.
At the height of clinical manifestations, the pathogen can be isolated by a biological method. For this purpose, the patient's blood, the contents of a bubo or skin ulcer are injected into a white mouse or guinea pig subcutaneously or intraperitoneally. In the case of tularemia infection, the animal dies and the pathogen is isolated from its organs by sowing the material on McCoy's coagulated yolk medium.
Differential diagnostics
Tularemia is differentiated from bacterial lymphadenitis, diphtheria, Simanovsky-Rauchfuss angina, tuberculosis of the lymph nodes, sepsis, typhoid and typhus, anthrax, and plague.
- Bacterial lymphadenitis, unlike tularemia, develops quickly, involving the skin and subcutaneous tissue.
- With anthrax, edema, severe infiltration and necrosis appear on the skin, and local insensitivity develops.
- In the bubonic form of plague, the lymph nodes are very painful and have smoothed shapes due to the development of periadenitis. The general condition is sharply impaired.
- Simanovsky-Rauchfuss angina has less pronounced (both local and general) manifestations compared to the angina-bubonic form of tularemia.
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