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There have never been any reports of abdominal complications in tularemia. The spleen, liver and suprarenals seem to bear the brunt of the localized abdominal pathologic changes in this disease, as shown by areas of focal necrosis of the miliary type. This is especially true in infected wild rodents, in which extensive study has been done by Francis and his co-workers during the past fifteen years.
In man, however, there has not been ample opportunity to make a thorough pathologic study because of the very low human mortality in tularemia. The examination of the abdominal organs of one patient who died five months after contracting tularemia showed pathologic changes not unlike those of chronic granulomas in the spleen, liver, lungs and suprarenals.
The case reported here apparently was an ordinary attack of tularemia until abdominal complications arose three months after the initial infection. The abdominal condition, which resembled that of
FULMER SC, KILBURY MJ. TULAREMIC PERITONITIS. JAMA. 1927;89(20):1661–1662. doi:10.1001/jama.1927.02690200013004
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