Septic pneumonic tularaemia caused by Francisella tularensis subsp. holarctica biovar II.
This case of pneumonic tularaemia elucidates two aspects: it is believed to be the first documented case of bacteraemia caused by Francisella tularensis subsp. holarctica 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 F. tularensis subsp. holarctica 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 degrees 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 F. tularensis subsp. holarctica infections may cause severe symptoms but mostly have a favourable outcome.
Clinic for Internal Medicine, HELIOS Klinik Zwenkau, Zwenkau, Germany.
Joerg
J
Fritzsch
German National Reference Laboratory for Tularaemia, Department of Immunology, Bundeswehr Institute of Microbiology, München, Germany.
Wolf D
WD
Splettstoesser
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D005604:Francisella tularensis / Q000145:classification* / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology*; D014406:Tularemia / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents