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October 24, 1936

TULAREMIA WITH PLEURAL EFFUSIONCASE IN WHICH BACTERIUM TULARENSE WAS ISOLATED FROM PLEURAL FLUID DURING LIFE

JAMA. 1936;107(17):1365-1367. doi:10.1001/jama.1936.02770430015005
Abstract

During the thirty years that tularemia has been recognized, interest has increased in the pleuropulmonary manifestations of the disease. Blackford1 recently reported a series of thirty-five consecutive cases of tularemia, of which approximately half showed clinical evidence of involvement of the thoracic viscera and more then 90 per cent showed x-ray abnormalities that might be attributed to the disease; he concluded that intrathoracic infection was frequent in patients who recover. He classifies the clinical signs in the chest as (1) tularemic pneumonia, (2) tularemic bronchitis and (3) tularemic pleural effusion. Archer, Blackford and Wissler2 describe the roentgenologic observations in the same series of cases. Tularemia with pleural effusion seems to be the least frequent of the three, appearing in Blackford's series in three cases, compared with seven each of tularemic pneumonia and bronchitis. Since tularemia with pleural effusion, in the weeks following the acute onset, so closely resembles

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