Tularemia is a zoonotic disease caused by the bacterium Francisella tularensis. The predominant sources, routes of infection, and clinical manifestations of human infections greatly vary according to the geographic area considered. Moreover, clinical suspicion of tularemia is often tricky because of the lack of specificity of the clinical manifestations. Because F. tularensis isolation is tedious and detection of its DNA usually requires removal of infected tissues, serological techniques are most often used for diagnostic confirmation. However, these techniques are varied and poorly standardized. The microagglutination test (MAT), the indirect immunofluorescence assay (IFA), and ELISA tests are currently the most frequently used techniques. These home-made and commercial tests are mainly used for tularemia diagnosis but also seroprevalence studies. ELISA tests detect specific antibodies within two weeks of disease evaluation, compared to 2–3 weeks for MAT and IFA. However, more false-positive results are usually reported with ELISA. The long-term persistence of anti-F. tularensis antibodies in patients with past tularemia infection hampers the diagnostic specificity of all these tests. Also, cross-reacting antibodies have been described (especially with Brucella and Yersinia species), although usually at a low level. The immunoblotting technique can highlight these serological cross-reactions. Tularemia remains an underdiagnosed disease in most endemic areas, and the clinical presentations of this disease are evolving. It is necessary to improve further speed and accuracy of tularemia diagnosis, as well as the standardization of diagnostic procedures.

Tularemia是一种由细菌引起的人畜共患疾病 图拉弗朗西斯菌。人类感染的主要来源，感染途径和临床表现根据所考虑的地理区域而有很大差异。此外，由于缺乏临床表现的特异性，临床上对Tularemia的怀疑常常是棘手的。因为图莱树分离很繁琐，检测其DNA通常需要去除受感染的组织，血清学技术最常用于诊断确认。但是，这些技术多种多样且标准化程度很差。微凝集试验（MAT），间接免疫荧光测定（IFA）和ELISA试验是目前最常用的技术。这些自制的和商业的测试主要用于Tularemia的诊断，还用于血清阳性率的研究。ELISA测试在疾病评估的两周内检测到特异性抗体，而MAT和IFA则为2-3周。但是，通常用ELISA报告更多假阳性结果。长期坚持反图莱树过去患有图拉血病感染的患者体内的抗体会影响所有这些检测方法的诊断特异性。同样，已经描述了交叉反应抗体（尤其是布鲁切拉 和 耶尔森氏菌种），尽管通常水平较低。免疫印迹技术可以突出这些血清学交叉反应。在大多数地方性疾病中，Tularemia仍未得到充分诊断，该疾病的临床表现也在不断发展。有必要进一步提高Tularemia的诊断速度和准确性，以及诊断程序的标准化。