Serendipitous Treatment of Tularemia in Pregnancy
We present a young pregnant woman who developed ulceroglandular tularaemia following a bite wound from a kitten. She grew Francisella tularensis from the ulcer. While awaiting bacterial culture results and serology for Bartonella, she was treated with azithromycin, with resolution of fever and axillary tenderness. Treatment recommendations for tularemia are either gentamicin or doxycycline, both of which can be perilous to the fetus. A Centers for Disease Control and Prevention report on the macrolide susceptibility of North American isolates of this organism has been underappreciated. The unanticipated result from this patient may give another potential option for treatment of tularemia in pregnancy.
Please know ticks transmit Tularemia: https://madisonarealymesupportgroup.com/2019/02/18/tularemia-in-minnesotan-ticks/
Now, Dr. Brown said an increasing number of cases of tularemia that were transmitted by a tick bite are being seen. Tularemia is transmitted by dog ticks, which also can transmit Rocky Mountain spotted fever. Lyme disease, babesiosis and erlichiosis, which are transmitted by tiny deer ticks, also occur on the Vineyard.
And with the relatively recent spread on the Island of lone star ticks, a new species, Dr. Brown said there is added concern about the potential for more disease transmission.