Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-A-5 – Tularemia ( Francisella tularensis )

Complications Complications include dehydration, hypotension, renal failure, disseminated intravascular coagulation (DIC), jaundice, hepatitis, meningitis, encephalitis, pericarditis, peritonitis, splenic rupture, rhabdomyolysis, suppuration of lymph nodes, and pleural effusion. Treatment delay and pre-existing medical conditions may contribute to death. Differential Diagnosis Other organisms to consider include Mycoplasma pneumoniae , Legionella pneumophila , Chlamydia psittaci , Chlamydia pneumoniae and Mycobacterium tuberculosis . Treatment (See Tables 1 and 2) Prophylaxis Antibiotic prophylaxis is not commonly used to preve nt naturally acquired tularemia. Isolation Standard Precautions are recommended. In addition to Standard Precautions, Contact precautions are recommended for patients with ulceroglandular or oculoglandular tularemia, if lesion drainage is not contained with a dressing.

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