The 41-year-old patient sits with heavy complaints to the family doctor. Suddenly she got a high fever, in addition, it suffers from head -, and limb pain. Also your lymph nodes on the left of the neck do not hurt. Any head movement is associated with pain.
The physician will prescribe you pain relievers and fever-lowering. A blood test gives no indication about what is causing the discomfort. The doctor assumes that the patient is suffering from a virus-caused inflammation of the brain. This skin is in contrast to a bacteria-triggered inflammation of the brain is not a medical emergency, but usually heals by itself.
Unusual experience while Jogging
The woman tells of an unusual experience that occurred six days earlier: While Jogging, in the Swiss Canton of Aargau to handle a Buzzard from behind. To your left of the back of the head, a bump was formed after that. The body is now caked, so you had a scratch injury. A connection with your current complaints, however, seems unlikely.
Her condition is not improving, unfortunately. Three days later, she will be delivering in a regional hospital in Switzerland. The Doctors there, examine the woman and the suspected diagnosis, an infection of the upper respiratory tract causing your symptoms. In addition, they document that the lymph nodes are swollen behind my left ear. Again the woman painkillers. Also anti-inflammatories to let the symptoms subside.
Five days later, she is released from the hospital, because she is symptom-free, but on your desire. For weeks she takes painkillers and anti-inflammatories to be healthy. Well, three weeks after the appointment with the doctor you will be transferred finally, in the infectious diseases Department of the cantonal hospital of Baden, because it is still bad.
There, the Doctors find that the woman has 40 degrees fever and muscle pain. At the back of the head, you see a small encrusted body, which is due to the Buzzard-attack. The nearby lymph nodes are still swollen.
The experts suspect that the patient suffers from a disease known hits are comparatively rare: tularemia, also called rabbit fever. It is caused by bacteria of the species Francisella tularensis. Try the pathogen in a blood culture of the patient to prove. The do not succeed. However, it is also known that the Culturing of F. tularensis in cultures fails more frequently in the laboratory. Nevertheless, the Doctors confirmed their suspicions, because in the blood of the woman’s numerous anti-body against rabbit fever pathogen.
Abscess of the lymph nodes
The patient is now receiving antibiotics to combat the bacteria. Slowly her fever subsides and she feels better again. However, the lymph nodes, where, in the meantime, a purulent abscess has formed, continue to be a Problem. The Doctors have to resort to the knife to let the pus drain out. After that, the lymph nodes heal.
Rare disease in humans
In the “Swiss archive for veterinary medicine” describes a Team of Infectious disease specialists and veterinarians to Felix Ehrensperger the unusual case. The rabbit plague mainly affects – as the Name field suggests, hares, as are rabbits and rodents are highly susceptible, write the experts. Cats, dogs, sheep, cattle, horses, birds – and people – not patients so easily. In Germany, the Robert Koch Institute per year are reported about 20 to 30 tularemia cases in humans. The Institute is a high number of unreported cases.
The disease can be transmitted by contact with infected animals to humans, including hunters and butchers may be infected when skinning. Similarly, Transfers by contaminated food, water or dust (for example, Heuarbeiten) or by tick bites are known. From person to person, the disease is not transmitted according to the current state of knowledge.
The Buzzard might have had bacteria on the claws, because he had captured infected rodents. Because of a Transmission by birds of prey has never been reported, it is called in the case report. It would also be possible, that the Buzzard with tularemia was infected.
When Buzzards attack people, usually because they want to protect their young birds. Joggers or walkers it can be – without that you are aware of the bird’s talent at all. At the point at which the patient was attacked, attacked by a Buzzard later, three more Jogger. In one of the Affected was actually diagnosed with a glandular fever.