title: Tularemia in a kidney transplant recipient: an unsuspected case and literature review.
abstract: Tularemia is a zoonotic infection that has rarely been reported in transplant recipients. The authors present a case of unsuspected tularemia in a kidney transplant patient that was diagnosed by isolation of Francisella tularensis in the blood. The patient was treated successfully with antibiotics. During diagnostic workup, a laboratory technician was exposed to tularemia by inhalation of the culture plate and received postexposure prophylaxis. This report emphasizes the importance of exposure history in the investigation of fever in an immunocompromised host and the special precautions needed when a virulent infectious organism is suspected.
authors.affiliation: Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA.
authors.forename: Jad A
authors.initials: JA
authors.lastname: Khoury
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Bohl
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hersh
authors.forename: Alexis C
authors.initials: AC
authors.lastname: Argoudelis
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
mesh_terms: D000368:Aged; D000818:Animals; D000835:Animals, Wild; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001769:Blood / Q000382:microbiology; D015897:Comorbidity; D004781:Environmental Exposure; D005604:Francisella tularensis / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D017758:Infectious Disease Transmission, Patient-to-Professional; D019570:Inhalation Exposure; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D017056:Medical Laboratory Personnel; D009784:Occupational Diseases / Q000209:etiology / Q000382:microbiology; D006109:Poaceae / Q000382:microbiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000382:microbiology; D014406:Tularemia / Q000175:diagnosis* / Q000635:transmission