Tularemia

Tularemia, also known as rabbit fever or deer fly fever, is a rare infectious disease caused by the highly virulent gram-negative bacterium Francisella tularensis. It is not a genetic disorder but rather a zoonotic infection acquired through contact with infected animals (particularly rabbits, hares, and rodents), bites from infected ticks or deer flies, inhalation of contaminated aerosols, ingestion of contaminated water or food, or handling of contaminated materials. The disease can affect multiple body systems depending on the route of infection. Tularemia presents in several clinical forms. Ulceroglandular tularemia (ICD-10: A21.0) is the most common, characterized by a skin ulcer at the site of inoculation with regional lymphadenopathy. Oculoglandular tularemia (A21.1) involves conjunctival infection with periauricular lymph node swelling. Pulmonary tularemia (A21.2) affects the lungs and can cause pneumonia, which is the most severe form. Gastrointestinal tularemia (A21.3) presents with abdominal pain, vomiting, and diarrhea. Generalized tularemia (A21.7) can involve septicemia and multi-organ involvement. Common symptoms across forms include sudden high fever, chills, headache, muscle aches, and fatigue. Without treatment, the disease can be life-threatening, particularly the pneumonic and typhoidal forms. Treatment is based on antibiotic therapy, with aminoglycosides such as streptomycin and gentamicin considered first-line agents. Doxycycline and ciprofloxacin are effective alternatives. Early diagnosis and prompt treatment significantly improve outcomes, with mortality rates dropping from up to 30-60% in untreated pneumonic or typhoidal forms to less than 2% with appropriate antibiotic therapy. Francisella tularensis is classified as a Category A bioterrorism agent due to its high infectivity and potential for aerosolized dissemination. There is currently no widely available licensed vaccine, though research efforts continue.

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