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Case Reports
. 2023 Jun 7:45:101882.
doi: 10.1016/j.rmcr.2023.101882. eCollection 2023.

Francisella tularensis subsp. holarctica bacteraemia in an immunocompetent male

Niels Schepens  1 , Thessa Verniest  2 , Isabel Verstreken  3 , Liesbet Henckaerts  1   4
Affiliations
Case Reports

Francisella tularensis subsp. holarctica bacteraemia in an immunocompetent male

Niels Schepens et al. Respir Med Case Rep. .

Abstract

Tularemia is a rare zoonotic disease caused by the two predominant subspecies of Francisella tularensis, namely subspecies tularensis and subspecies holarctica. The latter is less virulent than the former, is endemic in Europe, and usually has a mild disease course, although respiratory involvement and bacteraemia can occur. Tularemia in Belgium is rare, but the incidence seems to be increasing. It therefore seems prudent to raise awareness among clinicians for this potentially severe disease. We report the first case of pneumonic tularemia with bacteraemia from Belgium, and want to recommend including Francisella tularensis in the differential diagnosis of pneumonia when an unfavorable evolution is seen with standard treatment.

Keywords: Fever of unknown origin; Francisella tularensis; Tick-borne disease; Tularemia.

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Conflict of interest statement

The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication.

Figures

Image 1
Image 1
Computed tomography (CT) of the chest at admission shows nodular infiltrates of the lower lobes (left). A CT-scan performed after one week shows progression of the nodular infiltrates and development of a bilateral pleural effusion (right).
Image 2
Image 2
a 18F-fluorodeoxyglucose positron emission tomography CT, performed after drainage of the right-sided pleural effusion, shows FDG-captivating nodular densities spread across the lungs and accompanying hilar, paraesophageal and mediastinal adenopathies.
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See this image and copyright information in PMC

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