Tularaemia in children in Khanty-Mansiysk autonomous District-Ugra

Abstract

The aim of our study was the analysis of morbidity and clinical couse of tularemia in Khanty-Mansiysk autonomous District – Ugra for the period 2007–2015 timeframe. The highest incidence of tularemia in the Khanty-Mansiysk noted in the year 2013 (1036.6 о/0000), mainly urban residents (91%). The proportion of children among the sick (1005 people) accounted for 16%. Reviewed the clinical manifestations of tularemia among hospitalized children in 62 children’s infection Department for the period from 19 August to September 3, 2013 year ranging in age from 2 months to 18 years. The dominant clinical form of tularemia (98%) diagnosed ulceroglandular, easy (18%) and moderate (82%). The main clinical manifestations of tularemia in children was a triad of symptoms: ulcer of skin, fever, and lymphadenitis. Dominated femoral and inguinal lymphadenitis (55%), and in the head and neck region (29%), somewhat less frequently axillary (16%) Ultrasonography of lymph nodes with color Doppler mapping (Colour Doppler Imaging – CDI) allows you to assess the dynamics of the process and identify the presence of abscedirovania (5% of cases). 77% of cases have highlighted the febrile fever (39-40ºС), lasting an average of 4,0 ± 0,28 days. 26% of children noted chills, pain in muscles, joints and bones, weakness, loss of appetite, 24% there was a rash all over the body surface, 35% of patients have appeared anemia, 18% of patients have proteinuria was observed (up to 1 g/l), the presence of acetone and ketone bodies in the urine. At 94% of children with tularemia detected blood inflammatory changes in the form of moderate Leukocytosis, increased erythrocyte sedimentation rate, an increase in the level of c-reactive protein. Shows the high efficiency of treatment with an antibiotic in children of tularemia aminoglycoside-amikacin. Are 2 clinical observation.