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Infectious disease

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Diagnosis of tularemia

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Tularemia is diagnosed on the basis of a combination of clinical, epidemiological and laboratory data. From epidemiological data, contact with animals in the natural focus of infection is most important.

For laboratory confirmation, RA and RPHA are used. Specific antibodies begin to appear at the end of the 1st or at the beginning of the 2nd week from the onset of the disease and reach a maximum at the 4-6th week. The diagnostic titer is 1: 100 and higher.

At the height of clinical manifestations, the pathogen can be isolated by a biological method. To this end, the patient's blood, the contents of the bubo or cutaneous ulcer is injected with a white mouse or guinea pig subcutaneously or intraperitoneally. With tularemia infection, the animal dies and a pathogen is isolated from its organs by sowing the material on McCoy's folded yolk medium.

Differential diagnostics

Tularemia is differentiated with bacterial lymphadenitis, diphtheria, Simanovsky-Rauhfus angina, lymph node tuberculosis, sepsis, abdominal and typhus, anthrax, plague.

Bacterial lymphadenitis, in contrast to tularemia, develops rapidly, with the involvement of the skin and subcutaneous tissue.
With anthrax on the skin, edema appears, marked infiltration and necrosis, and local insensitivity develops.
With the bubonic form of the plague, the lymph nodes are very painful, have smooth forms due to the development of periadenitis. Sharply violated the general condition.
Angina Simanovsky-Raukhfusa has less pronounced (both local and general) manifestations compared with the anginous-bubonic form of tularemia.

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