Page 88 - Journal of Special Operations Medicine - Winter 2016

The 1996 case definition re-published in the 1999 CSTE position statement 1999-ID-6 and the 2009 CSTE position statement 1999, and 2010 versions of the case definition are identical.

Comments appearing on this page was 09-ID-66. Thus, the 1996,

Case Classification Confirmed Probable A clinically A clinically compatible compatible case with case with confirmatory laboratory laboratory results results indicative of presumptive infection

Table 1 Tularemia (Francisella tularensis) 1999 Case Definition [CSTE Position Statement(s) 09-ID-66]
Clinical diagnosis is bite, exposure to tissues water.
Exposure supported by evidence or history of a tick or deerfly of a mammalian host of F. tularensis, or exposure to potentially contaminated

Laboratory Criteria for Diagnosis Confirmatory Isolation of F. tularensis in a clinical specimen, OR Fourfold or greater change in serum antibody titer to F. tularensis antigen

Presumptive Elevated serum antibody titer(s) to Francisella tularensis antigen (without documented fourfold or greater change) in a patient with no history of tularemia vaccination, OR Detection of F. tularensis in a clinical specimen by fluorescent assay Source: https://wwwn.cdc.gov/nndss/conditions/tularemia/case-definition/1999/.

Clinical Description: An illness characterized by several distinct forms, including the following: Ulceroglandular: cutaneous ulcer with regional lymphadenopathy Glandular: regional lymphadenopathy with no ulcer Oculoglandular: conjunctivitis with preauricular lymphadenopathy Oropharyngeal: stomatitis or pharyngitis or tonsillitis and cervical lymphadenopathy Intestinal: intestinal pain, vomiting, and diarrhea Pneumonic: primary pleur

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