Types Of Tularemia And Their Symptoms

Also known as rabbit fever, tularemia is a rare type of infectious disease caused by the Francisella tularensisbacterium. The disease affects humans and other mammals, including rabbits, mice, and squirrels. Humans can become infected with tularemia after being bitten by a tick or deer fly that carries the bacteria. Drinking contaminated water, having skin contact with an infected animal, and laboratory exposure are other possible routes of transmission for this disease. After exposure, symptoms can begin in as little as three days to five days. For some types of tularemia, symptoms may not appear until two weeks after infection. In the United States, this condition is most prevalent in the western and southern parts of the country, and several hundred cases are diagnosed each year across the nation. Blood tests and sputum samples can be used to diagnose tularemia, and doctors may also perform a chest x-ray to check for complications such as pneumonia. If a diagnosis of tularemia is confirmed, clinicians will provide treatment with antibiotics. Streptomycin or gentamicin may be administered as injections, and doxycycline and other oral antibiotics might be needed as well.

Fever is a symptom that occurs with all types of tularemia, and some patients with the condition may have a fever as high as 104 degrees Fahrenheit. The other symptoms vary widely depending on which type of tularemia a patient has. The major types and signs associated with tularemia are discussed below.

Ulceroglandular Tularemia

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Ulceroglandular tularemia is the most common form of tularemia, and it is normally transmitted through a bite from an infected tick, mosquito, or deer fly. Individuals who have handled infected animals may also develop this type of tularemia. Ulcers, one of the defining features of this form of the condition, typically appear on the skin at the site where the bacteria enters the body, and some patients may have a rash at the infection site. In addition, lymph nodes near the ulcer will become swollen and painful, and this often occurs in the lymph nodes of the groin or armpits. Some patients may experience chills, headaches, joint pain, a sore throat, and diarrhea with this type of tularemia. Many patients also feel very fatigued with this infection. The ulcers and skin rashes associated with this form of the disease may need to be dressed and treated with medication to prevent blistering, and doctors will carefully monitor swollen lymph nodes to make sure they resolve.

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Oculoglandular Tularemia

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This form of tularemia occurs when the Francisella tularensis bacterium enters the body through the eyes. Patients may contract this type of tularemia if they touch their eyes while handling or butchering an animal infected with the bacterium. Transmission may also take place if a drop of blood from an infected organism enters the eye through splashing. Symptoms that can occur with oculoglandular tularemia include eye pain, sensitivity to light, redness of the eyes, and discharge from the eyes. Some patients may also develop swelling of the eyes, and an ulcer could form on the inside of the eyelid. The lymph nodes around the ear, neck, and jaw may become swollen and tender too. To prevent oculoglandular tularemia, experts advise individuals to wear gloves and protective eyewear when handling animals that could carry Francisella tularensis.

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Oropharyngeal Tularemia

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Oropharyngeal tularemia affects the mouth, throat, and digestive system. It is most often transmitted through eating undercooked meat from infected animals or through drinking contaminated water. The most frequent route of transmission for this type of the disease is eating rabbit meat. Patients with oropharyngeal tularemia typically experience a sore throat and mouth ulcers, and these may be accompanied by nausea or vomiting. The lymph nodes in the neck usually swell, and the tonsils might also become inflamed. In the later stages, diarrhea and abdominal pain could develop. If oropharyngeal tularemia advances without treatment, it may lead to gastrointestinal bleeding. To reduce the risk of this form of tularemia, researchers recommend cooking all meat, including wild game, to a minimum temperature of 165 degrees Fahrenheit. This cooking temperature is sufficient to kill Francisella tularensis.

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Pneumonic Tularemia

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Pneumonic tularemia involves the lungs, and it is transmitted when an individual inhales Francisella tularensisbacteria that has become airborne. Although among the rarest types of this condition, it is also one of the most severe forms of tularemia for humans. Patients are at risk of contracting this variety of tularemia when they do gardening, construction work, or other activities that disturb the soil. Laboratory workers who work with this disease are at an increased risk of pneumonic tularemia, and the condition can develop when other less serious forms of tularemia are left untreated. The symptoms associated with pneumonic tularemia are similar to pneumonia and include chest pain, a dry cough, and breathing difficulties. As this condition progresses, patients might develop a lung abscess or pleural effusion (an accumulation of fluid around the lungs). This form of tularemia may require the use of intravenous antibiotics, and patients will need to be closely monitored for potential complications such as pericarditis (inflammation of the membrane that protects the heart). To reduce their risk of pneumonic tularemia, lab workers and individuals who garden or work with soil should wear face masks.

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Typhoidal Tularemia

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This form of tularemia accounts for ten to fifteen percent of all diagnosed cases, and it is considered the most serious type of the disease. The method of transmission for this variety is currently unknown, but scientists believe it is most likely acquired by ingestion of contaminated food or drink. Pneumonia is one of the major symptoms associated with typhoidal tularemia, and this form is known to cause especially high fevers. Patients may also have diarrhea, vomiting, and severe fatigue, and some individuals will experience enlargement of the spleen or liver. As the most serious form of tularemia, this type is associated with severe complications, including hepatitis (an inflammation of the liver), sepsis (a blood infection), and osteomyelitis (bone infections).

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