1887

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Volume 59, Issue 9

Septic pneumonic tularaemia caused by subsp. biovar II Free

Abstract

This case of pneumonic tularaemia elucidates two aspects: it is believed to be the first documented case of bacteraemia caused by subsp. biovar II; furthermore, it illustrates the remission of septic pneumonic tularaemia without appropriate anti-infective therapy. A blood culture from a patient with community-acquired pneumonia was found to be positive for subsp. biovar II after 10 days of cultivation. Meanwhile, the patient had been treated with ceftriaxone, followed by sultamicillin and clindamycin. The patient continued suffering from fever of up to 40.7 °C and rising C-reactive protein (CRP) for 4 days before the fever and CRP declined. The isolated strain was later tested and found to be resistant to the antibiotics used. The present case underlines that subsp. infections may cause severe symptoms but mostly have a favourable outcome.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): CRP, C-reactive protein
SGM
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2010-09-01
2024-04-19
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References

  1. Baker C. N., Hollis D. G., Thornsberry C. 1985; Antimicrobial susceptibility testing of Francisella tularensis with a modified Mueller-Hinton broth. J Clin Microbiol 22:212–215
     [Google Scholar]
  2. Borner K., Lode H., Hampel B., Pfeuffer M., Koeppe P. 1985; Comparative pharmacokinetics of ceftriaxone after subcutaneous and intravenous administration. Chemotherapy 31:237–245 [CrossRef]
     [Google Scholar]
  3. Broekhuijsen M., Larsson P., Johansson A., Byström M., Eriksson U., Larsson E., Prior R. G., Sjöstedt A., Titball R. W., Forsman M. 2003; Genome-wide DNA microarray analysis of Francisella tularensis strains demonstrates extensive genetic conservation within the species but identifies regions that are unique to the highly virulent F.tularensis subsp. tularensis . J Clin Microbiol 41:2924–2931 [CrossRef]
     [Google Scholar]
  4. Cross J. T., Jacobs R. F. 1993; Tularemia: treatment failures with outpatient use of ceftriaxone. Clin Infect Dis 17:976–980 [CrossRef]
     [Google Scholar]
  5. Eliasson H., Bäck E. 2007; Tularaemia in an emergent area in Sweden: an analysis of 234 cases in five years. Scand J Infect Dis 39:880–889 [CrossRef]
     [Google Scholar]
  6. Feldman K. A., Stiles-Enos D., Julian K., Matyas B. T., Telford S. R., Chu M. C., Petersen L. R., Hayes E. B. 2003; Tularemia on Martha's Vineyard: seroprevalence and occupational risk. Emerg Infect Dis 9:350–354 [CrossRef]
     [Google Scholar]
  7. Gutiérrez M. P., Bratos M. A., Garrote J. I., Dueñas A., Almaraz A., Alamo R., Rodríguez Marcos H., Rodríguez Recio M. J., Muñoz M. F. other authors 2003; Serologic evidence of human infection by Francisella tularensis in the population of Castilla y León (Spain) prior to 1997. FEMS Immunol Med Microbiol 35:165–169 [CrossRef]
     [Google Scholar]
  8. Harrell R. E., Simmons H. F. 1990; Pleuropulmonary tularemia: successful treatment with erythromycin. South Med J 83:1363–1364 [CrossRef]
     [Google Scholar]
  9. Hauri A. M., Hofstetter I., Seibold E., Kaysser P., Eckert J., Neubauer H., Splettstoesser W. D. 2010; An airborne outbreak of tularemia in Germany – epidemiological and laboratory investigations. Emerg Infect Dis 16:238–243 [CrossRef]
     [Google Scholar]
  10. Hoel T., Scheel O., Nordahl S. H., Sandvik T. 1991; Water- and airborne Francisella tularensis biovar palaearctica isolated from human blood. Infection 19:348–350 [CrossRef]
     [Google Scholar]
  11. Jenzora A., Jansen A., Ranisch H., Lierz M., Wichmann O., Grunow R. 2008; Seroprevalence study of Francisella tularensis among hunters in Germany. FEMS Immunol Med Microbiol 53:183–189 [CrossRef]
     [Google Scholar]
  12. Porsch-Özcürümez M., Kischel N., Priebe H., Splettstoesser W., Finke E. J., Grunow R. 2004; Comparison of enzyme-linked immunosorbent assay, Western blotting, microagglutination, indirect immunofluorescence assay, and flow cytometry for serological diagnosis of tularaemia. Clin Diagn Lab Immunol 11:1008–1015
     [Google Scholar]
  13. Siret V., Barataud D., Prat M., Vaillant V., Ansart S., Le Coustumier A., Vaissaire J., Raffi F., Garré M., Capek I. 2006; An outbreak of airborne tularaemia in France; August 2004 Euro Surveill 11:58–60
     [Google Scholar]
  14. Splettstoesser W. D., Kopf S. 2008; Zur Häufung von Tularämie-Erkrankungen in Deutschland im Jahr 2007. Epidemiol Bull 4:30 http://www.rki.de/cln_169/nn_504578/DE/Content/Infekt/EpidBull/Archiv/2008/04__08,templateId=raw,property=publicationFile.pdf/04_08.pdf
     [Google Scholar]
  15. Splettstoesser W. D., Piechotowski I., Buckendahl A., Frangoulidis D., Kaysser P., Kratzer W., Kimmig P., Seibold E., Brockmann S. O. for the EMIL Study Group. 2009; Tularemia in Germany: the tip of the iceberg?. Epidemiol Infect 137:736–743 [CrossRef]
     [Google Scholar]
  16. Splettstoesser W. D., Seibold E., Zeman E., Trebesius K., Podbielski A. 2010; Rapid differentiation of Francisella species and subspecies by fluorescent in situ hybridization targeting the 23 S rRNA. BMC Microbiol 10:72 [CrossRef]
     [Google Scholar]
  17. Tomaso H., Al Dahouk S., Hofer E., Splettstoesser W. D., Treu T. M., Dierich M. P., Neubauer H. 2005; Antimicrobial susceptibilities of Austrian Francisella tularensis holarctica biovar II strains. Int J Antimicrob Agents 26:279–284 [CrossRef]
     [Google Scholar]
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Septic pneumonic tularaemia caused by Francisella tularensis subsp. holarctica biovar II
J. Med. Microbiol. 59, 1123 (2010); https://doi.org/10.1099/jmm.0.019893-0
/content/journal/jmm/10.1099/jmm.0.019893-0
/content/journal/jmm/10.1099/jmm.0.019893-0
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