Hostname: page-component-84b7d79bbc-tsvsl Total loading time: 0 Render date: 2024-07-25T12:43:40.894Z Has data issue: false hasContentIssue false
  • English
  • Français

Bronchial changes in airborne tularemia

Published online by Cambridge University Press:  29 June 2007

Hannu Syrjälä ,
Seppo Sutinen ,
Kalevi Jokinen ,
Pentti Nieminen ,
Tuula Tuuponen  and
Aimo Salminen
Hannu Syrjälä*
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
Seppo Sutinen
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
Kalevi Jokinen
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
Pentti Nieminen
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
Tuula Tuuponen
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
Aimo Salminen
Affiliation:
Departments of Medicine, Pathology, Otolayngology and Medical Microbiology, University of Oulu, Oulu; Oulaskangas Hospital, Oulainen; and Päivärinne Hospital, Jokirinne, Finland.
*
Hannu Syrjälä, M.D., Department of Medicine, Oulu University Central Hospital, Kajaanintie 50 SF-90220 Oulu 22, Finland.
Get access Rights & Permissions [Opens in a new window]

Abstract

We describe seven typhoidal tularemia patients without ulcers or lymphadenopa-thy, who underwent diagnostic bronchoscopy. Four patients had had obvious airborne exposure to F. tularensis during farming activities, and the remaining three had respiratory symptoms also. Bronchoscopical findings were pathological in all cases, varying from local to diffuse haemorrhagic inflammation; in one case a granulomatous tumour was seen. Early histopathological changes in three biopsies consisted of haemorrhagic oedema progressing to a non-specific inflammatory reaction, which could still be found 45 days after the onset of symptoms. Granulomatous inflammation, indistinguishable from tuberculosis or sarcoidosis, was seen in four biopsies from two patients, three to seven months after the onset. Most patients had radiographic hilar enlargement. We conclude that transmission of typhoid tularemia usually occurs through inhalation leading to bronchial changes, which correspond skin ulcerations in ulcero-glandular tularemia, the hilar enlargement corresponding to the lymph node component. We emphasize that usage of the term ‘typhoidal’ tularemia should be discontinued. Instead, tularemia transmitted through inhalation should be called pulmonary or respiratory.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 100 , Issue 10 , October 1986 , pp. 1169 - 1176
Copyright
Copyright © JLO (1984) Limited 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Avery, P. W., and Barnett, T. (1967) Pulmonary tularemia: A report of five cases and consideration of pathogenesis and terminology. American Review of Respiratory Disease, 95: 584–591.Google Scholar
Baskerville, A. and Hambleton, P. (1976) Pathogenesis and pathology of respiratory tularemia in the rabbit. British Journal of Experimental Pathology, 57: 339–347.Google ScholarPubMed
Baskerville, A., Hambleton, P. and Dowsett, A. B. (1978) The pathology of untreated and antibiotic-treated experimental tularemia in monkeys. British Journal of Experimental Pathology, 57: 615–623.Google Scholar
Bellanti, J. A., Buescher, E. L., Brandt, W. E., Dangerfield, H. G. and Crozier, D. (1967) Characterization of human serum and nasal hemagglutinating antibody to Farncisella tularensis. The Journal of Immunology, 98: 171–178.CrossRefGoogle ScholarPubMed
Cluxton, H. E., Cliffton, E. E. and Worley, J. A. (1948) Primary tularemia of the lungs masquerading as other forms of lung pathology. Journal of Arkansas Medical Society, 44: 266–275.Google ScholarPubMed
Dahlstrand, S., Ringertz, O. and Zetterberg, B. (1971) Airborne tularemia in Sweden. Scandinavian Journal of Infectious Diseases, 3: 7–16.CrossRefGoogle ScholarPubMed
Francis, E. and Callender, G. R. (1927) Tularemia: The microscopic changes of lesions in man. Archives of Pathology and Laboratory Medicine, 3: 577–607.Google Scholar
Goodpasture, E. W. and House, S. J. (1928) The pathologic anatomy of tularemia in man. American Journal of Pathology, 4: 213–226.Google ScholarPubMed
Justaz, H. J. (1961) World-Atlas of Epidemic diseases, Hamburg: Falk verlag, 38 pp.Google Scholar
Kavanaugh, C. N. (1935) Tularemia: A consideration of one hundred and twenty-three cases, with observation at autopsy in one. Archives of Internal Medicine, 55: 61–68.CrossRefGoogle Scholar
Kitamura, S., Fukada, M., Takeda, H., Ouchi, S., Nahano, S. and Unagami, T. (1956) Pathology of tularemia. Acta Pathologica Japonica, 6: 719–764.CrossRefGoogle Scholar
Lillie, R. D. and Francis, E. (1936) The pathology of tularemia in Man. National Institute of Health Bulletin, 167: 1–91.Google Scholar
McCoy, G. W. (1911) A plague-like disease in rodents. Public Health Bulletin, 43: 53–71.Google Scholar
McCrumb, F. R. (1961) Aerosol infection of man with Pasteurella tularensis. Bacterial Reviews, 25: 262–267.CrossRefGoogle ScholarPubMed
Permar, H. H. and Maclahlan, W. W. G. (1931) Tularemia pneumonia. Annals of Internal Medicine, 5: 687–698.Google Scholar
Pittman, B., Shaw, E. B. and Cherry, W. R. (1977) Isolation of Francisella tularensis from infected frozen human blood. Journal of Clinical Microbiology, 5: 621–624.CrossRefGoogle ScholarPubMed
Puntigam, F. (1960) Erkrankungen an torakalen Formen der Tuläramie bei Arbeitnehmern in Zuckerfabriken. Zeitschrift für Hygiene, 147: 162–168.CrossRefGoogle Scholar
Sutinen, S. and Syrjälä, H. (1986) Histopathology of human lymph node tularemia caused by F. tularensis var pataelarctica. Archives of Pathology and Laboratory Medicine, 110: 42–46.Google Scholar
Syrjälä, H., Karvonen, J. and Salminen, A. (1984) Skin manifestation of tularemia: A study of 88 cases in northern Finland during 16 years (1967–1983). Acta Dermatovenereologica (Stockholm), 64: 513–516.Google ScholarPubMed
Syrjälä, H., Kujalä, P., Myllylä, V. and Salminen, A. (1985) Airborne transmission of tularemia in farmers. Scandinavian Journal of Infectious Diseases, 17: 371–375.Google ScholarPubMed
Teutsch, S. M., Martone, W. J., Brink, E. W., Potter, M. E., Eliot, G., Hoxsie, W. J., Craven, R. B. and Kaufmann, A. F. (1979). Pneumonic tularemia on Martha's Vineyard. New England Journal of Medicine, 301 826–828.CrossRefGoogle ScholarPubMed