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Symptoms of tularemia
Last reviewed: 20.11.2021
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Bubonic form of tularemia occurs when penetrating the pathogen through the skin. It is characterized by swelling of lymph nodes near the gate of infection. More often one grows, less often a few lymph nodes. Bubbons moderately painful, with clear contours, the size of a chicken egg. Subsequently, buboes can slowly dissolve, but often on the 3-4th week from the moment they appear they soften, get nagged, the skin over them becomes edematous and hyperemic. Bubon is opened with the release of creamy pus. A fistula is formed, followed by scarring and sclerosing.
Ulcerative bubonic form of tularemia usually occurs with a bite of infected mites, flies, mosquitoes, etc. At the site of the bite, after 1 or 2 days a spot is formed, then a papule, a vesicle, a pustule, an ulcer. The ulcer heals slowly, for 2-3 weeks or even 1-2 months.
An anginous-bubonic form of tularemia occurs when alimentary infection occurs. Patients complain of pain in the throat, difficulty in swallowing. Palatine tonsils swollen, hyperemic, with foci of necrosis and overlap, which are difficult to remove and can resemble plaque in the diphtheria of throat. However, plaque in tularemia often occurs on one amygdala, never spreads beyond the amygdala and is relatively quickly necrotic with the formation of deep, slowly healing ulcers. The process in throat is accompanied by regional lymphadenitis with possible suppuration and scarring.
The eyeball-shaped form of tularemia occurs when the pathogen penetrates the conjunctiva of the eye. Initially there are conjunctivitis, a papule and soon a sore with a purulent discharge. Regional lymph nodes (submandibular, parotid, proneusheynye) become painful and dense. The process is usually one-sided, rarely two-sided. Possible damage to the cornea.
The pulmonary form of tularemia occurs with airborne dust infection with bronchial and lung lesions. Patients complain of pain in the chest, dry cough, which in the future can be accompanied by the release of mucopurulent sputum. On the roentgenogram, there are enlarged basal, paratracheal and mediastinal lymph nodes. Possible development of disseminated foci in the lungs, abscess, pleurisy.
The abdominal form of tularemia is manifested by strong paroxysmal pains in the abdomen, which can mimic an acute abdomen due to a sharp increase in the mesenteric lymph nodes. There is nausea, vomiting, flatulence, stool retention, sometimes diarrhea, enlarged liver and spleen.
The generalized form of tularemia usually develops in weakened children with altered reactivity and is accompanied by general toxic symptoms. The disease begins suddenly with pronounced symptoms of intoxication. Cramps, nonsense, loss of consciousness are possible. There are severe headaches, adynamia, anorexia, muscle pains. Often there is a symmetrically located spotted-papular rash on the limbs, face and neck. Arterial blood pressure is lowered, cardiac tones are deaf. The liver and spleen are enlarged from the first days of the disease.
With tularemia, meningoencephalitis, myocarditis, and secondary pneumonia are possible.