Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Tularemia (Francisella tularensis)
1996 Case Definition

Clinical Description

An illness characterized by several distinct forms, including the following:

  • Ulceroglandular: cutaneous ulcer with regional lymphadenopathy
  • Glandular: regional lymphadenopathy with no ulcer
  • Oculoglandular: conjunctivitis with preauricular lymphadenopathy
  • Oropharyngeal: stomatitis or pharyngitis or tonsillitis and cervical lymphadenopathy
  • Intestinal: intestinal pain, vomiting, and diarrhea
  • Pneumonic: primary pleuropulmonary disease
  • Typhoidal: febrile illness without early localizing signs and symptoms
Clinical diagnosis is supported by evidence or history of a tick or deerfly bite, exposure to tissues of a mammalian host of Francisella tularensis, or exposure to potentially contaminated water.

Laboratory Criteria for Diagnosis

Presumptive

  • Elevated serum antibody titer(s) to F. tularensis antigen (without documented fourfold or greater change) in a patient with no history of tularemia vaccination, OR
  • Detection of F. tularensis in a clinical specimen by fluorescent assay
Confirmatory
  • Isolation of F. tularensis in a clinical specimen, OR
  • Fourfold or greater change in serum antibody titer to F. tularensis antigen

Case Classification

Probable

A clinically compatible case with laboratory results indicative of presumptive infection

Confirmed

A clinically compatible case with confirmatory laboratory results



Top