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Case Reports
. 2023 Jun 7:33:e01812.
doi: 10.1016/j.idcr.2023.e01812. eCollection 2023.

Acute left knee prosthetic joint infection by Francisella tularensis with literature review

Javier Escovar  1 , Sachin M Patil  2 , William Roland  3
Affiliations
Case Reports

Acute left knee prosthetic joint infection by Francisella tularensis with literature review

Javier Escovar et al. IDCases. .

Abstract

Tularemia is a severe zoonotic disease caused by gram-negative bacillus Francisella tularensis. F. tularensis species account for most cases in the United States of America (USA). Apart from the six classical clinical presentations that include glandular, ulceroglandular, oculoglandular, pharyngeal, typhoidal, and pneumonic, skeletal disease is uncommon. Rare clinical manifestations include primary and secondary skin rashes, erythema nodosum, and erythema multiforme. Infrequent skeletal manifestations have presented as osteomyelitis and prosthetic joint infections. Prosthetic joint infection by F. tularensis is a rarity. PubMed literature review revealed a total of five prosthetic joint infection cases. Here we report the sixth and the third case in the USA in a 73-year-old white male with an acute left knee prosthetic joint infection (occurring after a recent episode of left lower extremity cellulitis with septic shock) successfully treated with 14 days of doxycycline.

Keywords: Doxycycline; Francisella tularensis; Prosthetic joint infection; Tularemia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Anteroposterior and lateral view of left knee (at Orthopedic clinic) revealed primary cemented components with good alignment and no evidence of loosening.
See this image and copyright information in PMC

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