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Arch Intern Med. 1996 Oct 14;156(18):2137-40.

Tularemia presenting as community-acquired pneumonia. Implications in the era of managed care.

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Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Calif., USA.


A case of pleuropulmonary tularemia was diagnosed by sputum culture and serologic studies in a patient who did not have classic epidemiological risks for tularemia. The patient had atypical pneumonia when initially seen and his condition slowly improved with antibiotic therapy that included erythromycin lactobionate. The diagnosis of tularemia was delayed because the gram-negative rod isolated from the patient's sputum was initially not speciated in an effort to reduce laboratory costs.

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