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      Tularemia presenting as suspected necrotic arachnidism

      case-report

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Key Clinical Message

          The true danger of the spider bite stems from misdiagnosis and resultant delay in proper treatment of entities that, unlike spider bites, are not self‐limited. Obtaining a complete exposure and travel history is central to the development of an accurate and appropriate differential diagnosis.

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          Splenomegaly: investigation, diagnosis and management.

          Anna L. Pozo, Edmund M Godfrey, Kristian Bowles (2009)
          Splenomegaly is a feature of a broad range of diseases, and presents to clinicians in many fields. This review examines the aetiology of splenomegaly in the developed world, and describes a logical approach to the patient with splenomegaly. In some patients, extensive radiological and laboratory investigations will fail to yield a diagnosis: these cases of "isolated" splenomegaly are not uncommon and can be particularly challenging to manage. The risks of serious underlying disease must be balanced against the risks of invasive investigations such as splenic biopsy and diagnostic splenectomy. We discuss the options in isolated splenomegaly and their evidence base, and incorporate them into a management strategy to aid the clinician in cases of diagnostic difficulty.
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            Tularemia.

            Sarah Wingerter, Lise Nigrovic (2008)
            Tularemia is a rare zoonotic infection caused by the bacterium Francisella tularensis. The disease is endemic in North America and parts of Europe and Asia. Arthropods (ticks and deer flies) are the main transmission vector, and small animals (rabbits, hares, and muskrats) serve as reservoir hosts. The clinical presentation depends on the bacterial subspecies and the route of infection. Recent world events have led to a new recognition of F tularensis as a viable agent of bioterrorism, which has sparked a renewed focus on this pathogen.
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              Notes from the Field: Increase in Human Cases of Tularemia--Colorado, Nebraska, South Dakota, and Wyoming, January-September 2015.

              Caitlin Pedati, Jennifer House, Jessica B. Hancock-Allen … (2015)
              Tularemia is a rare, often serious disease caused by a gram-negative coccobacillus, Francisella tularensis, which infects humans and animals in the Northern Hemisphere. Approximately 125 cases have been reported annually in the United States during the last two decades. As of September 30, a total of 100 tularemia cases were reported in 2015 among residents of Colorado (n = 43), Nebraska (n = 21), South Dakota (n = 20), and Wyoming (n = 16) (Figure). This represents a substantial increase in the annual mean number of four (975% increase), seven (200%), seven (186%) and two (70%) cases, respectively, reported in each state during 2004-2014.
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                Author and article information

                Contributors
                Heather F. Sateia:
                ORCID: http://orcid.org/0000-0001-8591-938X
                hsateia1@jhmi.edu
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 06 March 2017
                Publication date Collection: April 2017
                Volume: 5
                Issue: 4 ( doiID: 10.1002/ccr3.2017.5.issue-4 )
                Pages: 497-500
                Affiliations
                [ 1 ] Division of General Internal Medicine Department of MedicineJohns Hopkins University School of Medicine Baltimore MarylandUSA
                [ 2 ] Division of Infectious Disease Department of MedicineJohns Hopkins University School of Medicine Baltimore MarylandUSA
                Author notes
                [*] [* ] Correspondence

                Heather F. Sateia, Johns Hopkins School of Medicine, 10753 Falls Road / Suite 325, Lutherville, MD 21093, USA. Tel: 1‐410‐583‐2929; Fax: 1‐410‐583‐2883; E‐mail: hsateia1@ 123456jhmi.edu

                Author information
                http://orcid.org/0000-0001-8591-938X
                Article
                Publisher ID: CCR3882
                DOI: 10.1002/ccr3.882
                PMC ID: 5378850
                SO-VID: b0f86a44-cca9-486d-b73b-3772cc2221fe
                Copyright © © 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 May 2016
                Date revision received : 13 October 2016
                Date accepted : 25 January 2017
                Page count
                Figures: 3, Tables: 0, Pages: 4, Words: 2390
                Categories
                Subject: Case Report
                Subject: Case Reports
                Custom metadata
                source-schema-version-number 2.0
                component-id ccr3882
                cover-date April 2017
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.9 mode:remove_FC converted:04.04.2017

                Keywords: arachnidism,necrotic skin lesion,spider bite,splenomegaly,tick bite,tularemia
                Data availability:
                Keywords: arachnidism, necrotic skin lesion, spider bite, splenomegaly, tick bite, tularemia

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