• Clinical and Experimental Pediatrics
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• v.58 no.10
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• pp.398-401
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• 2015

Tularemia is a potentially severe zoonotic disease caused by Francisella tularensis. A lack of awareness about tularemia can be embarrassing and could result in delayed treatment because of improper diagnosis. The diagnosis of tularemia is difficult, because the infections are rare and the clinical spectrum is broad. As only 1 adult case has been reported in Korea thus far, pediatricians in Korea may be unfamiliar with tularemia. We report our experience with a 14-year-old male adolescent with tularemia who presented with atypical pneumonia and possible infective endocarditis. Although the infectivity and mortality rates for tularemia are very high if left untreated, we did not suspect tularemia in this case until the incidental isolation of F. tularensis. The present case suggests that clinicians in Korea should be more aware of tularemia. This case also suggests that tularemia should be considered in undetermined cases of atypical pneumonia or acute febrile illness without local signs.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.49-52
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• 2018

Purpose: Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment. Methods: A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included. Results: Before diagnosis, the duration of symptoms in patients was $32.15{\pm}17.8days$. The most common lymph node localization was the cervical chain. All patients received medical treatment (e.g., streptomycin, gentamicin, ciprofloxacin, and doxycycline). Patients who had been given streptomycin, gentamicin, or doxycycline as initial therapy for 10-14 days showed no response to treatment, and recovery was only achieved after administration of oral ciprofloxacin. Response to treatment was delayed in 5 patients who had been given ciprofloxacin as initial therapy. Surgical incision and drainage were performed in 9 patients (47.5%) who were unresponsive to medical treatment and were experiencing abcess formation and suppuration. Five patients (26.3%) underwent total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to reach a conclusive differential diagnosis and inform treatment. Conclusion: The causes of treatment failure in tularemia include delay in effective treatment and the development of suppurating lymph nodes.

• Journal of the korean veterinary medical association
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• v.38 no.9
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• pp.781-800
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• 2002

Recently, biological weapons (BWs) prepared with pathogenic microorganisms, toxins and biological vectors have been used maliciously for biological warfare, bioterrorism and/or agroterrorism by hostile countries and terrorists. In this review, historical background of disease and malicious use of BWs pathogenicity of microorganisms, advanced methodology involved in laboratory diagnosis, and prevention and control of anthrax (Bacillus anthracis), plague (Yersinia pseudotuberculosis subs. pestis), glanders (Burkholderia mallei), and smallpox (Variola virus) which have been abused for biological warfare or bioterrorism were discussed. In addition, the pathogenicity of microorganisms and the methodology needed to diagnose and control 6 diseases identified by WHO/CDC, ie., smallpox, inhalation anthrax, pneumonic plague, botulism, tularemia, and hemorrhagic fevers that would wreak havoc if terrorists successfully disseminated the germs by air were described.