Die Tularämie in Deutschland

Zusammenfassung

Das Bakterium Francisella tularensis ist inzwischen seit mehr als 100 Jahren als Verursacher der Tularämie, einer in der gesamten nördlichen Hemisphäre verbreiteten Zoonose, bekannt. Die Prävalenz der Tularämie zeigt große geographische Schwankungen, wobei die Erkrankung in Deutschland vergleichsweise selten vorkommt. Die klinischen Manifestationsformen der Tularämie sind vielfältig und umfassen ulzeroglanduläre, glanduläre, oropharyngeale, okuloglanduläre, respiratorische sowie typhoide Verläufe. Aufgrund der niedrigen Prävalenz und der unspezifischen Symptomatik gelingen eine rasche Diagnosestellung sowie der frühe Beginn einer wirksamen Therapie eher selten. Daher fassen wir in diesem Artikel wesentliche Aspekte zu Ätiologie, Ökologie und Infektionswegen, aktueller epidemiologischer Situation, klinischem Bild, Diagnostik sowie Therapie der Tularämie zusammen mit Schwerpunkt auf der Situation in Deutschland.

Abstract

The bacterium Francisella tularensis is known for more than 100 years by now as the etiological agent of the disease tularemia, a zoonotic infection with a worldwide distribution in the Northern Hemisphere. The prevalence of tularemia shows a wide geographic variation, being comparably infrequent in Germany. Tularemia can present itself with multiple clinical manifestations including ulceroglandular, glandular, oropharyngeal, oculoglandular, respiratory and typhoidal forms. Due to the low prevalence and the unspecific symptomatology, a rapid diagnosis and early start of an effective therapy are rarely obtained. Thus, in this article we summarize important aspects concerning etiology, ecology and routes of transmission, recent epidemiologic situation, clinical picture, diagnostics and treatment of tularemia, focusing on the situation in Germany.

Schlüsselwörter

Tularämie - Francisella tularensis - Ätiologie - Manifestationsformen - Diagnostik - Therapie

Keywords

tularemia - Francisella tularensis - etiology - clinical manifestations - diagnostics - therapy

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