Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- febre
- linfadenopatia
- úlceras cutâneas dolorosas
- conjuntivite unilateral
Other diagnostic factors
- cefaleia
- mal-estar/fadiga
- mialgia
- anorexia
- dor abdominal
- vômitos
- estertores
- tosse não produtiva/dispneia
- faringite
- fotofobia
- comprometimento/perda da visão
- icterícia, hepatoesplenomegalia, diarreia
- sinal de Brudzinski/Kernig positivo, rigidez no pescoço
Risk factors
- exposição ao carrapato
- exposição à picada de mosca
- contato com animais infectados
- trabalho em ambientes externos onde vivem animais infectados
- primavera ou verão
Diagnostic investigations
1st investigations to order
- Hemograma completo
- níveis de eletrólitos séricos
- TFHs
- creatina quinase sérica
- tira reagente para exame de urina para sangue
- velocidade de hemossedimentação
- sorologia
- hemocultura
- cultura de espécime
- reação em cadeia da polimerase de swab de úlcera ou aspirado de linfonodo
Investigations to consider
- radiografia torácica
- punção lombar
- histopatologia
Emerging tests
- detecção do antígeno na urina
Treatment algorithm
tularemia sem meningite
meningite tularêmica
Contributors
Authors
William A. Petri, Jr., MD, PhD, FACP
Wade Hampton Frost Professor of Epidemiology
Professor of Medicine, Microbiology, and Pathology
Chief, Division of Infectious Diseases and International Health
University of Virginia
Charlottesville
VA
Disclosures
WAP declares that he has no competing interests.
Peer reviewers
Christopher Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
Burlington
VT
Disclosures
CH declares that he has no competing interests.
Beth Kirkpatrick, MD
Assistant Professor
Infectious Diseases
University of Vermont College of Medicine
Burlington
VT
Disclosures
BK declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022 [internet publication].Full text
World Health Organization (WHO). WHO Guidelines on tularaemia. 2007 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Bacteremia tularêmica
- Doença por arranhadura do gato
- Toxoplasmose
More DifferentialsDiretrizes
- Tickborne diseases of the United States: a reference manual for health care providers
- Tularaemia control guideline
More Diretrizes
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