Tularemia and the oculoglandular syndrome of Parinaud

An 18-year-old female came to our clinic with complaints of a tender lump just under her jaw on the left side and another lump in front of her left ear, ecchymosis around the eye and some redness in the eye at the same side. After administering antibiotic therapy for two days we suspected of tularemia and referred the patient to the Infectious Diseases Department. A serum sample was taken and a fine needle aspiration biopsy was performed. The patient was diagnosed with tularemia, the oculoglandular syndrome of Parinaud. Tularemia should also be kept in mind for differential diagnosis in patients with both ocular and glandular symptoms in endemic regions like Turkey and the appropriate therapy should be initiated immediately.

Tularemia in children.

OBJECTIVE: Tularemia, an infection caused by the coccobacilus Francisella tularensis, can be a difficult disease process to diagnose and treat. The aim of this study was to evaluate an epidemic of tularemia in Bursa. METHODS: In this study, we included only pediatric cases. All the cases were diagnosed on clinical and serological grounds. RESULTS: During an epidemic of tularemia in a village of Bursa on December 2004, 70 people (60 adults, 10 children) fell ill. In children with tularemia, the oropharyngeal form predominated which was diagnosed 70% of cases. Most of the patients (80%) who had older than 10 years old, were treated with doxycycline. All patients recovered without complications. CONCLUSION: The epidemic was thought to be waterborne. The vehicle of the infections was inadequately treated water which was used by the patient in the village.

Cytokine response in Balb/c mice infected with Francisella tularensis LVS and the Pohang isolate

We investigated the immune response induced by the Francisella (F.) tularensis live vaccine strain (LVS) and the Pohang isolate. After the Balb/c mice were infected intradermally (i.d) with 2 x 10(4) cfu of F. tularensis LVS and Pohang, respectively, their blood and organs were collected at different times; 0, 3, 6, 24, 72, 96, 120 and 168 h after infection. Using these samples, RT-PCR and ELISA analysis were carried out for the comparative study of the cytokines, including TNF-alpha, INF-gamma, IL-2, IL-4, IL-10 and IL-12. In the Pohang-infected mice at 120 h, the liver showed a 53 times higher level of TNF-alpha and a 42 times higher level of IFN-gamma than the respective levels at the early time points after infection. The levels of TNF-alpha and IFN-gamma induced by LVS were 5 times lower than those induced by the Pohang isolate. Also, the organs from the Pohang-infected mice showed higher levels of TNF-alpha, IFN-gamma, IL-10 and IL-12 than the levels in the LVS-infected mice. The blood from the Pohang-infected mice at 120 h revealed about a 40 times increased level of IFN-gamma, and IL-10 was also increased by 4 times at 96 h compared to an early infection time point, while IL-4 was not induced during the whole infection period. These results suggest that F. tularensis may induce a Th1-mediated immune response to in vivo infection and the Pohang isolate has a higher capacity than the LVS to induce an acute immune response in Blab/c mice.

Infecciones graves de vías respiratorias superiores / Severe infections of upper respiratory tract

Las enfermedades de vías respiratorias superiores y sus complicaciones pueden poner en peligro la vida; por consiguiente, se necesita un método sistemático para el diagnóstico rápido y tratamiento adecuado. Al analizar los signos y síntomas se puede establecer un diagnóstico diferencial. Las infecciones graves de vías respiratorias superiores pueden situarse en tres categorías expuestas en este artículo: síndrome catarral agudo, síndrome de amigdalofaringitis o síndrome de crup laríngeo. Este sistema de clasificación hace que el diagnóstico sea rápido y permita que el tratamiento adecuado se inicie con prontitud