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...
Published in: | Annals of Clinical Microbiology and Antimicrobials |
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ftunivtampere:oai:trepo.tuni.fi:10024/152597 2024-01-07T09:45:28+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. Tampere University Fimlab Laboratories PLC BioMediTech 2023-12 1012933 fulltext https://trepo.tuni.fi/handle/10024/152597 https://doi.org/10.1186/s12941-023-00642-7 en eng 92 1 22 1476-0711 ORCID: /0000-0002-9830-0823/work/146561901 https://trepo.tuni.fi/handle/10024/152597 URN:NBN:fi:tuni-202311139606 doi:10.1186/s12941-023-00642-7 cc by 4.0 openAccess 318 Medical biotechnology 3111 Biomedicine article 2023 ftunivtampere https://doi.org/10.1186/s12941-023-00642-7 2023-12-14T00:09:39Z 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. Peer reviewed Article in Journal/Newspaper Northern Finland Tampere University: Trepo Annals of Clinical Microbiology and Antimicrobials 22 1 |
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Tampere University: Trepo |
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English |
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318 Medical biotechnology 3111 Biomedicine |
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318 Medical biotechnology 3111 Biomedicine 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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318 Medical biotechnology 3111 Biomedicine |
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. Peer reviewed |
author2 |
Tampere University Fimlab Laboratories PLC BioMediTech |
format |
Article in Journal/Newspaper |
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 |
publishDate |
2023 |
url |
https://trepo.tuni.fi/handle/10024/152597 https://doi.org/10.1186/s12941-023-00642-7 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_relation |
92 1 22 1476-0711 ORCID: /0000-0002-9830-0823/work/146561901 https://trepo.tuni.fi/handle/10024/152597 URN:NBN:fi:tuni-202311139606 doi:10.1186/s12941-023-00642-7 |
op_rights |
cc by 4.0 openAccess |
op_doi |
https://doi.org/10.1186/s12941-023-00642-7 |
container_title |
Annals of Clinical Microbiology and Antimicrobials |
container_volume |
22 |
container_issue |
1 |
_version_ |
1787427004036939776 |