Tularemia Cases in Childhood - Original Investigation

Objective: The purpose of this study was to evaluate childhood tularemi from the treatment and clinical aspects. Material and Methods: Sixteen cases admitted with lymphadenopathy and with Francisella tularensis anticor titer of 1/160 and above in the microagglutination test were investigated retrospectively.Their sociodemographic characteristics, contact with animals, history of tick bite, duration of complaint, clinical findings, laboratory findings, treatment and clinical courses were studied.Results: The average age was 10.3±3.7 (4-17) years. It was determined that the most frequent type is the glandular type (62.5%). Fifty seven percentage of all cases were suppurative, 12 % of these drained by itself. 56 percentage of the cases (n=9) were living rurally; 38% of the cases (n=6) had contact with contaminated water. Just 6% of the cases (n=1) had contact with animals.It was determined that patients admitted to hospital within 25 days after symptoms started recieved antibiotic treatment, which is ineffective in tularemia. It was noted that 11 patients with suppurative lymph nodes were admitted to hospital in 30 days, while others were admitted l in 15 days (p=0.030). It was determined that cases with lymph nodes suppurative received typical antibiotic treatment for 17 days, others received typical antibiotic treatment for 9 days (p=0.021). Gentamisin treatment was started in 14 patients (88%) and doxicycline treatment was started in 2 patients (12%). Proportion of unresponsiveness to Gentamisin treatment was calculated as 37.5%.Conclusion: To keep infection under control it is very important to investigate whether there are patients with similar complaints in the same area, to request a microagglutination test in cases suspected of having tularemia and to start appropriate treatment early.