Identification of Francisella tularensis in ascites in the context of typhoidal tularaemia.

Suter, Philipp; Duerig, Marco; Haefliger, Emmanuel; Chuard, Christian (2024). Identification of Francisella tularensis in ascites in the context of typhoidal tularaemia. BMJ case reports, 17(3) BMJ Publishing Group 10.1136/bcr-2023-256509

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Tularaemia is a highly infectious, zoonotic disease caused by Francisella tularensis, which has become increasingly prevalent over the past decade. Depending on the route of infection, different clinical manifestations can be observed. We report a case of typhoidal tularaemia presenting as a febrile illness with gastrointestinal symptoms in a patient in her mid-80s. During the acute illness phase and in the context of alcohol-related liver cirrhosis, the patient developed progressive ascites. During paracentesis, spontaneous bacterial peritonitis was consistently reported. Blood culture revealed Gram-negative bacilli identified as F. tularensis upon microscopic examination. Immediate clinical improvement was observed after adaptation to a pathogen-specific antibiotic regime. Typhoidal tularaemia presents general, non-specific symptoms without the local manifestations seen in other forms of the disease, thus representing a diagnostic challenge. In the case of protracted fever and if the epidemiological context as well as possible exposure are compatible, tularaemia should be considered in the differential diagnosis.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Suter, Philipp, Dürig, Marco Reto, Häfliger, Emmanuel (A)

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-790X

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 Apr 2024 15:01

Last Modified:

02 Apr 2024 15:01

Publisher DOI:

10.1136/bcr-2023-256509

PubMed ID:

38553022

Uncontrolled Keywords:

Alcoholic liver disease General practice / family medicine Hepatitis and other GI infections Infection (gastroenterology) Liver disease

URI:

https://boris.unibe.ch/id/eprint/195434

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