Table of Contents
Definition / general | Diagnosis | Microscopic (histologic) description | Differential diagnosisCite this page: DePond WD. Tularemia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodestularemia.html. Accessed January 24th, 2021.
Definition / general
- Caused by Francisella tularensis, a gram negative coccobacilli found in rodents, rabbits and hares, transmitted by ticks and deer flies
- Commonly due to food and water contamination by rodents, hunting hares (Med Clin (Barc) 2002;119:455) and mosquito bites (Emerg Infect Dis 2002;8:956)
- Also a virulent, potential biowarfare agent (Centers for Disease Control and Prevention: Tularemia [Accessed 2 July 2018], eMedicine: Tularemia [Accessed 2 July 2018])
- Symptoms: sudden fever, chills, headaches, diarrhea, muscle aches, joint pain, dry cough, progressive weakness; also pneumonia, skin / mouth ulcers, lymphadenopathy, eye involvement
- Ulceroglandular form: prominent lymphadenopathy of either axilla (mammalian vectors, such as handling rabbits) or cervical / inguinal regions (arthropod vectors)
Diagnosis
- Rise in titers
- PCR (Mod Pathol 2004;17:489)
- Immunofluorescence (Scand J Infect Dis 2004;36:785)
Microscopic (histologic) description
- Early: reactive changes
- Second week: abscess with variable epithelioid cell reaction
- Fourth week: caseous necrosis, diffuse lymphadenitis
- Late: granulomatous reactions that may resemble TB
- Often extracapsular inflammation (Arch Pathol Lab Med 1986;110:42)
Differential diagnosis
