학술논문

Pneumonic tularaemia: experience of 58 cases from 2000 to 2012 in Northern Finland.
Document Type
Article
Source
Infectious Diseases. Oct2017, Vol. 49 Issue 10, p758-764. 7p.
Subject
*AGGLUTINATION tests
*BRONCHOSCOPY
*COMPUTED tomography
*LENGTH of stay in hospitals
*PNEUMONIA
*TREATMENT effectiveness
*DATA analysis software
*TULAREMIA
*SYMPTOMS
*PROGNOSIS
*DIAGNOSIS
Language
ISSN
2374-4235
Abstract
Background: Pneumonic tularaemia is less common clinical form of tularaemia compared with the ulceroglandular form, with only a limited number of case reports and case series in Europe. In Finland, Northern Ostrobothnia is an endemic area of tularaemia with occasional seasonal outbreaks. Methods: In our study, a consecutive series of 58 pneumonic tularaemia cases diagnosed and treated in Oulu University Hospital in 2000–2012 were retrospectively analysed in terms of epidemiology, clinical course, and prognosis. Results: The incidence of pneumonic tularaemia showed peaks in cycles of a few years and most cases were diagnosed in late summer or early autumn. Respiratory symptoms were absent in 47% of patients, and 7% had normal chest X-ray. The chest computed tomography (CT) was performed in 81% of patients, demonstrating variable findings associated with pneumonic tularaemia. Bronchoscopy was performed for 22 (38%) patients and four (18%) of these also proceeded into mediastinoscopy. Moreover, thoracoscopy was performed for one (2%) patient. Two (3%) patients were treated shortly in the intensive care unit (ICU) during their stay in hospital. No mortality was observed. Conclusions: Most cases of pneumonic tularaemia are diagnosed during the seasonal outbreaks. The lack of specific symptoms often complicates the diagnosis and leads to unnecessarily invasive examinations. [ABSTRACT FROM AUTHOR]