Tularemia
Pathogen: Francisella tularensis |
Tick vectors: Amblyomma americanum, Dermacentor variabilis, Dermacentor andersoni |
Geographic distribution: South-central region |
Classic presentation: Ulceroglandular: Red painful papule at the site of tick exposure that evolves into a black eschar; fever, headache, myalgia, malaise, lymphadenopathy Glandular: Same as ulceroglandular except primary lesion not recognized |
Diagnosis: 4-fold increase between the acute and convalescent sera or a single titer ≥ 1:160; culture may also be performed |
Treatment: Streptomycin or gentamicin for at least 10 days; for less severe disease, ciprofloxacin or doxycycline for 14 days |