Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 25, Number 10—October 2019

Early Diagnosis of Tularemia by Flow Cytometry, Czech Republic, 2003–20151

Aleš ChrdleComments to Author , Pavlína Tinavská, Olga Dvořáčková, Pavlína Filipová, Věra Hnetilová, Pavel Žampach, Květoslava Batistová, Václav Chmelík, Amanda E. Semper, and Nick J. Beeching
Author affiliations: České Budějovice Hospital, České Budějovice, Czech Republic (A. Chrdle, P. Tinavská, P. Filipová, V. Hnetilová, P. Žampach, V. Chmelík); University of South Bohemia Faculty of Health and Social Sciences, České Budějovice, Czech Republic (A. Chrdle, O. Dvořáčková); Royal Liverpool University Hospital, Liverpool, UK (A. Chrdle, N.J. Beeching); Písek Hospital, Písek, Czech Republic (K. Batistová); Public Health England, Porton Down, UK (A.E. Semper); National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK (A.E. Semper; N.J. Beeching); Liverpool School of Tropical Medicine, Liverpool (N.J. Beeching)

Main Article

Table 2

Final diagnoses of 342 control group patients with negative serologic test results for tularemia and percentages of controls with elevated CD3+/CD4–/CD8– T cells, Czech Republic, 2012–2015*

Diagnosis No. (%) controls† No. (%) with elevated CD3+/CD4–/CD8– T cells
Nonspecific resolving lymphadenitis 99 (28.9) 7 (7.1)
Fever of unknown origin or fatigue 44 (12.9) 2 (4.5)
Epstein-Barr virus or cytomegalovirus 26 (7.6) 3 (11.5)
Lymphoma or cancer 26 (7.6) 1 (3.8)
Chlamydia or Mycoplasma respiratory infection 25 (7.3) 5 (20.0)
Recurring or nonresolving tonsilitis 17 (5.0) 4 (23.5)
Toxoplasmosis 16 (4.7) 5 (31.3)
Other‡ 89 (26.0) 9 (10.1)§

*The percentage of the CD3+ T cells with a CD4–/CD8– phenotype was measured by flow cytometry and 8% was used as the cutoff value to define an elevated percentage. ANCA, anti-neutrophil cytoplasmic antibody.
†Percentages do not total 100% because of rounding.
‡Other diagnoses: 8 cases each of cellulitis or skin abscess and lower respiratory tract infection or pneumonia; 5 cases of bartonellosis; 4 cases each of ANCA-positive vasculitis, leptospirosis, purulent sialadenitis, reactive arthritis (urethritis C. trachomatis), and tick-borne encephalitis; 3 cases of cervical cyst; 2 cases each of HIV, human granulocytic anaplasmosis, other reactive arthritis, polymyalgia rheumatica, sarcoidosis, systemic lupus erythematosus, toxocariasis, and viral meningitis; and 1 case each of acute sinusitis, ankylosing spondylitis, bacterial endocarditis, Behçet disease, cholangitis, deep vein thrombosis, dental abscess, erythema nodosum, farmer’s lung, hantavirus, herpetic tonsilitis, hidradenitis suppurativa, hyperthyroidism, hypothyroidism, legionellosis, lipoma, liver abscess, Lyme disease, mumps, necrotizing lymphadenitis of Kikuchi-Fujimoto, nonspecific hepatitis, parvovirus B19, pertussis, recurrent bacterial conjunctivitis, rickettsial disease, ulcerative colitis, undetermined tumor of the brain and pancreatic head, urinary tract infection, and Yersinia enterocolitica arthritis.
§Includes 2 cases of arthralgia and 1 case each of ANCA-positive vasculitis, brain tumor, liver abscess, pneumocystis pneumonia in the setting of AIDS, rickettsial disease, skin and soft tissue infection, and toxocariasis.

Main Article

1Preliminary data from this study were presented at the European Congress of Clinical Microbiology and Infectious Diseases; April 9–12, 2016; Amsterdam, the Netherlands (abstract no. O367).

Page created: September 17, 2019
Page updated: September 17, 2019
Page reviewed: September 17, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.