Diagnosis of tularemia using biochemical, immunochemical and molecular methods: a review

Tularemia, an infection caused by the intracellular gram-negative bacterium Francisella tularensis, is accompanied by high mortality and occurs throughout the Northern Hemisphere. The causative agent is also considered one of the most important biological warfare agents. As well as its taxonomy and epidemiology, the basic immunochemical, biochemical, and molecular approaches for disease diagnosis are outlined in this review. Aspects of immune responses during tularemia and damage to specific organs are discussed with regards to the predictive value of standard biomarkers. Bacterial burden is also considered as a limitation for polymerase-chainreaction-based diagnosis.