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Tularemia: A Case Series of Patients Diagnosed at the National Reference Center for Rickettsioses From 2008 to 2017.
- Source :
-
Open forum infectious diseases [Open Forum Infect Dis] 2020 Sep 19; Vol. 7 (11), pp. ofaa440. Date of Electronic Publication: 2020 Sep 19 (Print Publication: 2020). - Publication Year :
- 2020
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Abstract
- Background: We describe the epidemiological, clinical, and prognostic aspects of 177 tularemia cases diagnosed at the National Reference Center for rickettsioses, coxiellosis, and bartonelloses between 2008 and 2017.<br />Methods: All patients with a microbiological diagnosis of tularemia made in the laboratory were included. Clinical and epidemiological data were collected retrospectively from clinicians in charge of patients using a standardized questionnaire. Diagnostic methods used were indirect immunofluorescence serology, real-time polymerase chain reaction (PCR), and universal PCR targeting the 16S ribosomal ribonucleic acid gene.<br />Results: The series included 54 females and 123 males (sex ratio, 2.28; mean age, 47.38 years). Eighty-nine (50.2%) were confirmed as having tularemia on the basis of a positive Francisella tularensis PCR or seroconversion, and 88 (49.8%) were considered as probable due to a single positive serum. The regions of France that were most affected included Pays de la Loire (22% of cases), Nouvelle Aquitaine (18.6% of cases), and Grand Est (12.4% of cases). Patients became infected mainly through contact with rodents or game (38 cases, 21.4%), through tick-bites (23 cases, 12.9%), or during outdoor leisure activities (37 cases, 20.9%). Glandular and ulceroglandular forms were the most frequent (109 cases, 61.5%). Two aortitis, an infectious endocarditis, a myocarditis, an osteoarticular infection, and a splenic hematoma were also diagnosed. Tularemia was discovered incidentally in 54.8% of cases. Seventy-eight patients were hospitalized, and no deaths were reported.<br />Conclusions: Our data suggest that in an endemic area and/or in certain epidemiological contexts, tularemia should be sought to allow an optimized antibiotic therapy and a faster recovery.<br /> (© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Details
- Language :
- English
- ISSN :
- 2328-8957
- Volume :
- 7
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Open forum infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 33209946
- Full Text :
- https://doi.org/10.1093/ofid/ofaa440