Positive Francisella tularensis meningitis outcome despite delayed identification: a case report
Francisella tularensis is a Gram-negative bacteria, that may cause a zoonotic disease, tularemia. Here, we describe a patient case, where a previously healthy young woman in Northern Finland contacted health care because of fever and headache. Due to the symptoms and lack of further diagnostic tools...
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ftpubmed:oai:pubmedcentral.nih.gov:10598999 2023-11-12T04:23:15+01:00 Positive Francisella tularensis meningitis outcome despite delayed identification: a case report Mäki-Koivisto, Vesa Korkala, Marianne Simola, Lotta Suutari-Kontio, Sonja Koivunen, Sini Puhto, Teija Junttila, Ilkka S. 2023-10-24 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598999/ http://www.ncbi.nlm.nih.gov/pubmed/37875923 https://doi.org/10.1186/s12941-023-00642-7 en eng BioMed Central http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598999/ http://www.ncbi.nlm.nih.gov/pubmed/37875923 http://dx.doi.org/10.1186/s12941-023-00642-7 © BioMed Central Ltd., part of Springer Nature 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Ann Clin Microbiol Antimicrob Case Report Text 2023 ftpubmed https://doi.org/10.1186/s12941-023-00642-7 2023-10-29T01:02:04Z Francisella tularensis is a Gram-negative bacteria, that may cause a zoonotic disease, tularemia. Here, we describe a patient case, where a previously healthy young woman in Northern Finland contacted health care because of fever and headache. Due to the symptoms and lack of further diagnostic tools in primary health care, she was transferred to University Hospital (UH) where ampicillin and ceftriaxone was given empirically. A cerebrospinal fluid sample (CSF) was drawn showing small Gram-negative rods that grew on chocolate agar after 2 days of incubation. Matrix-assisted laser-desorption-ionization time of-flight (Maldi-tof) did not provide identification, but the bacteria was interpreted as sensitive to ciprofloxacin and the treatment was changed to ciprofloxacin. During the time the patient was infected, there were several positive tularemia samples found in the area. Therefore, an in house tularemia nucleic acid method (PCR) was used on the bacterial culture. Additionally, 16S rDNA sequencing was performed and these methods identified the bacteria as F. tularensis. Fortunately, the patient recovered completely with ciprofloxacin and was discharged without any complications. Our case underlines the need to understand the limits of specific diagnostic methods, such as Maldi-tof, used in clinical laboratory settings. It also highlights the need of both clinicians and laboratory staff to be aware of the many clinical presentations of tularemia when working in an endemic area. Text Northern Finland PubMed Central (PMC) Annals of Clinical Microbiology and Antimicrobials 22 1 |
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Case Report Mäki-Koivisto, Vesa Korkala, Marianne Simola, Lotta Suutari-Kontio, Sonja Koivunen, Sini Puhto, Teija Junttila, Ilkka S. Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
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Case Report |
description |
Francisella tularensis is a Gram-negative bacteria, that may cause a zoonotic disease, tularemia. Here, we describe a patient case, where a previously healthy young woman in Northern Finland contacted health care because of fever and headache. Due to the symptoms and lack of further diagnostic tools in primary health care, she was transferred to University Hospital (UH) where ampicillin and ceftriaxone was given empirically. A cerebrospinal fluid sample (CSF) was drawn showing small Gram-negative rods that grew on chocolate agar after 2 days of incubation. Matrix-assisted laser-desorption-ionization time of-flight (Maldi-tof) did not provide identification, but the bacteria was interpreted as sensitive to ciprofloxacin and the treatment was changed to ciprofloxacin. During the time the patient was infected, there were several positive tularemia samples found in the area. Therefore, an in house tularemia nucleic acid method (PCR) was used on the bacterial culture. Additionally, 16S rDNA sequencing was performed and these methods identified the bacteria as F. tularensis. Fortunately, the patient recovered completely with ciprofloxacin and was discharged without any complications. Our case underlines the need to understand the limits of specific diagnostic methods, such as Maldi-tof, used in clinical laboratory settings. It also highlights the need of both clinicians and laboratory staff to be aware of the many clinical presentations of tularemia when working in an endemic area. |
format |
Text |
author |
Mäki-Koivisto, Vesa Korkala, Marianne Simola, Lotta Suutari-Kontio, Sonja Koivunen, Sini Puhto, Teija Junttila, Ilkka S. |
author_facet |
Mäki-Koivisto, Vesa Korkala, Marianne Simola, Lotta Suutari-Kontio, Sonja Koivunen, Sini Puhto, Teija Junttila, Ilkka S. |
author_sort |
Mäki-Koivisto, Vesa |
title |
Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
title_short |
Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
title_full |
Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
title_fullStr |
Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
title_full_unstemmed |
Positive Francisella tularensis meningitis outcome despite delayed identification: a case report |
title_sort |
positive francisella tularensis meningitis outcome despite delayed identification: a case report |
publisher |
BioMed Central |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598999/ http://www.ncbi.nlm.nih.gov/pubmed/37875923 https://doi.org/10.1186/s12941-023-00642-7 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
Ann Clin Microbiol Antimicrob |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598999/ http://www.ncbi.nlm.nih.gov/pubmed/37875923 http://dx.doi.org/10.1186/s12941-023-00642-7 |
op_rights |
© BioMed Central Ltd., part of Springer Nature 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
op_doi |
https://doi.org/10.1186/s12941-023-00642-7 |
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Annals of Clinical Microbiology and Antimicrobials |
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22 |
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