Abstract:
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.
摘要:
Tularemia是由土拉弗朗西斯菌引起的人畜共患感染。它在人类中最典型的表现是溃疡性和腺体;假体关节的感染很少见。我们报告了2016-2019年期间在法国发生的3例与Tularensis亚种holarctica相关的人工关节感染。我们还回顾了相关文献,发现全球仅有5例其他Francisella相关人工关节感染病例。这是我们总结的。在这8名患者中,临床症状在关节置入后7天至19年出现,且对兔热病无特异性.虽然阳性培养通常仅在10%的兔热病病例中获得,菌株在所有8名患者中生长。通过基质辅助激光解吸/电离飞行时间质谱,最初在2例患者中鉴定出了F.tularensis;分子方法用于6例患者。手术治疗与长期抗菌治疗相结合可获得良好的结果;随访6个月后未见复发。