First case of tularemia in a 19-year-old Puerto Rican patient employed in a veterinary clinic

Although this patient did not show other complications following treatment, infection can occur if corrective measures are not taken.

Veterinarians and those who work on farms are the part of the population with the highest risk of contagion. Photo: Shutterstock.

A 19-year-old Puerto Rican girl was victim of bacteria Francisella tularic causandole infectionfollowing being exposed to animals in their home and work areabecoming the first case of tularemia reported on the island.

This disease usually occurs in USA. It is a bacterium that is housed in rabbits, rats, rodents and even in domestic animals, although in isolation. Veterinarians and those who work on farms are the part of the population with the highest risk of contagion. This might occur due to working with dead animal skin, food or water intake contaminated, ticks or some infected animal and also due to aerosol in laboratories.

This clinical case reached Hospital San Lucas in Poncewhere the doctor Marie Frances Ilarraza Lugoa second-year pediatric resident, presented the event and told MSP that patient She was working as a veterinary technician at the time of infection.

Doctora Marie Frances Ilarraza Lugo, second-year resident of pediatrics and part of the authors of the case. Photo: provided by Dr. Frances to the Journal of Medicine and Public Health.

“She arrived because she had two weeks with presentation and pain of a nodule in the submandibular area on the right side, and in that same eye, he had atypical conjunctivitis, yellow secretions, edema and ptosis. The patient was evaluated with an infectologist outside the hospital who thinks it is a malignant mass and orders admission, but the infectious part was included in the differential diagnoses -according to her history-, which is why a series of laboratories is ordered,” specified Ilarraza Lugo, who studied at the Ponce Health Sciences University.

Given the panorama, the symptoms were treated as those of a bacterium called Bartonella; antibiotics were ordered for five days and he was discharged the following day. However, following a week, the young woman began to have a fever and cough. “We sent her to look for admission because the titles of Francisella tularensis positive and treatment is started, which is intravenous gentamicin for seven days and he responded well and was discharged once more, with follow-up in ophthalmology and infectology“, he added.

Atypical presentations

The doctor indicated that the most common presentations are ulcerative, but the clinical case showed an oculoglandular problem, the least common. However, she specified that in some cases respiratory problems, meningitis or rashes may occur.

recommendations to avoid infection

Although this patient did not show other complications following treatment, infection can occur if you do not take the corrective measures. “Handling dead animals should be avoided; if you do, wear gloves and protective clothing. My recommendation in these cases is to abound in the history, because it is something that alerted us to carry out laboratories and see the presentations. If there is a person who explained, the incubation time is five days, although it can take up to twenty-one days and you should visit your doctor,” he warned.