%0 Journal Article
%T Case Studies and Literature Review of Francisella tularensis-Related Prosthetic Joint Infection.
%A Ponderand L
%A Guimard T
%A Lazaro E
%A Dupuy H
%A Peuchant O
%A Roch N
%A Deroche P
%A Ferry T
%A Maurin M
%A Hennebique A
%A Boisset S
%A Pelloux I
%A Caspar Y
%J Emerg Infect Dis
%V 29
%N 6
%D 2023 06
%M 37209668
%F 16.126
%R 10.3201/eid2906.221395
%X 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.