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Doi No: 10.5578/mb.57283

Doğu Anadolu Bölgesi'nden Hastanemize Başvuran Orofarengeal Tularemi Olgularının
Epidemiyolojik ve Klinik Özelliklerinin Değerlendirilmesi

Evaluation of Epidemiologic and Clinical Features of
Oropharyngeal Tularemia Patients in the Eastern Anatolia Region of Turkey

Kemalettin ÖZDEN1, Ayşe ÖZDEN2, Ayşe ALBAYRAK1, Zülal ÖZKURT1, Hakan DÖNERAY2, Mehmet PARLAK1


1 Atatürk Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Erzurum.

1 Atatürk University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey.

2 Atatürk Üniversitesi Tıp Fakültesi, Pediatrik Endokrinoloji Bilim Dalı, Erzurum.

2 Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey.

ABSTRACT

Tularemia is a zoonotic infectious disease caused by Francisella tularensis. Tularemia is endemic in the northern hemisphere and is usually seen in North America, Europe and Asia.  Although the ulceroglandular tularemia is the most common form in these regions, the oropharyngeal form is more prevalent in Eastern Europe, including Turkey. The disease  has importance in Turkey due to its wide geographic distribution and periodic outbreaks. The aim of this study was to determine the demographic, clinical and epidemiological characteristics of oropharyngeal tularemia patients. The demographic, clinical, epidemiological and laboratory findings of 26 tularemia patients admitted to our hospital from Erzurum and 5 neighbour provinces were analyzed retrospectively. Francisella tularensis microagglutination test (MAT) was performed for all patients whose clinical  symptoms were consistent with tularemia and MAT titers ≥ 1/160 were considered positive. Twenty-six oropharyngeal tularemia patients (13 males and 13 females) were included in the study. All of the patients had cervical lymphadenopathy (LAP) at least one month period. Twenty (76.9%) of the patients included in the study  were living in rural areas, and 17 (65.4%)  were dealing with livestock. It was determined that 9 (34.6%) of the patients used water from municipal water supply, 9 (34.6%) of the patients used water from natural water supply and 8 (30.8%) of the patients used both of the water supplies. The most common symptoms among the patients in the study were fever in 23 (88.5%) patients, sore throat in 24 (92.3%) patients, and cervical LAP in all of the patients. Thirteen (50%) of the patients were treated with streptomycin, 7 (26.9%) with doxycycline and  6 (23.1%) with gentamicin. This is the first study showing that tularemia is present in Erzincan, Ağrı, Iğdır as well as Erzurum provinces, and it provides that the incidence has increased in this region. Tularemia diagnosis is generally underestimated due to the lack of specific  symptoms. Therefore, tularemia should also be considered  in patients who have complaints of sore throat and cervical LAP in non-endemic regions.

Keywords: Francisella tularensis; tularemia; lymphadenopathy.

Anahtar sözcükler: Francisella tularensis; tularemi; lenfadenopati.

Geliş Tarihi (Received): 01.06.2017 - Kabul Ediliş Tarihi (Accepted): 25.11.2017

İletişim (Correspondence):

Dr. Ayşe Albayrak

Atatürk Üniversitesi Tıp Fakültesi,

Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı,

25040 Erzurum, Türkiye.

Tel (Phone): +90 505 668 4655,

E-posta (E-mail): aysealbayrakerz@gmail.com

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