Case Studies and Literature Review of Francisella tularensis –Related Prosthetic Joint Infection

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Ponderand, Léa | Guimard, Thomas | Lazaro, Estibaliz | Dupuy, Henry | Peuchant, Olivia | Roch, Nathalie | Deroche, Philippe | Ferry, Tristan | Maurin, Max | Hennebique, Aurélie | Boisset, Sandrine | Pelloux, Isabelle | Caspar, Yvan

Edité par CCSD ; Centers for Disease Control and Prevention -

International audience. Tularemia is a zoonotic infection caused by Francisella tularensis. Its most typical manifestations in humans are ulceroglandular and glandular; infections in prosthetic joints are rare. We report 3 cases of F. tularensis subspecies holarctica-related prosthetic joint infection that occurred in France during 2016-2019. We also reviewed relevant literature and found only 5 other cases of Francisella-related prosthetic joint infections worldwide, which we summarized. Among those 8 patients, clinical symptoms appeared 7 days to 19 years after the joint placement and were nonspecific to tularemia. Although positive cultures are typically obtained in only 10% of tularemia cases, strains grew in all 8 of the patients. F. tularensis was initially identified in 2 patients by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; molecular methods were used for 6 patients. Surgical treatment in conjunction with long-term antimicrobial treatment resulted in favorable outcomes; no relapses were seen after 6 months of follow-up.

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