Infection Caused byFrancisella philomiragia(FormerlyYersinia philomiragia)

Abstract

We evaluated the clinical characteristics of patients with Francisella philomiragia (formerly Yersinia philomiragia) isolated from normally sterile sites. Isolates from 14 patients were received by the Centers for Disease Control between 1975 and 1987: 9 were from blood; 2 from lung biopsies; and 1 each from pleural, peritoneal, and cerebrospinal fluid. Underlying problems included chronic granulomatous disease in 5 patients, near-drowning in 5, and a myeloproliferative disease in 2. All 13 patients for whom records were available had a febrile syndrome compatible with bacterial infection. Pneumonia and fever-bacteremia were the commonest clinical syndromes reported. In 7 cases, F. philomiragia was the only sterile-site isolate, and the clinical syndrome did not resolve without appropriate antibiotics. Familiarity with this organism is important because of its ability to cause serious disease in chronic granulomatous disease and near-drowning patients. Further study may yield new insights into pathogenic and host defense mechanisms.

Francisella philomiragia Adenitis and Pulmonary Nodules in a Child with Chronic Granulomatous Disease

“…Therapeutic failures involving F philomiragia infection have been documented, for example, despite apparent in vitro susceptibility to cephalosporins (5). While all 14 of the isolates initially described by Wenger et al (1) were susceptible to thirdgeneration cephalosporins, all produced beta-lactamase and were ampicillin-resistant. A more recent study (3) provided the first clinical report of in vitro cefotaxime resistance.…”

“…As noted by Wenger et al (1), patients fell into three main categories: CGD patients (mean age 14 years); patients that experienced near-drownings in saltwater; and adults with hematological malignancy. Only two cases had no discernable risk factor.…”

Detection of Francisella tularensis in infected mammals and vectors using a probe-based polymerase chain reaction.

“…This organism was formerly classified as Yersinia philomiragia 24,25 and exhibits a high degree (Ͼ98%) of 16S rRNA sequence homology with F. tularensis. 26 While a documented human pathogen, F. philomiragia is isolated mainly from immunocompromised patients, 24 and encountering it in a biological warfare/terrorism scenario is unlikely.…”

Francisellosis in fish: an emerging challenge

“…Recently, tularemia in Turkey has been associated with beaver, muskrat and voles which infect surface waters suggesting that the aquatic environment is an important risk factor in its epidemiology 20,21 . F. philomiragia is a rare disease and is associated with immune-compromised patients as in chronic granulomatous disease (CGD) and in near drowning events causing pneumonia or fever-bacteraemia 13,15,17 .…”

“…In Atlantic cod, emaciation, haemorrhagic skin and heart nodules also occur while in tilapia, gills can have the nodules in addition to exopthalmia and skin haemorrhages and scale loss 7,8 . Histopathology in affected organs feature granulomas consisting of vacuolated macrophages with the Francisella organisms, associated central necrosis and fibrous encapsulation 5,[7][8][9]12,13 , in the sub-acute (7 days post challenge 5 ) to chronic disease. Acute disease has been experimentally replicated causing 100% mortality by 72 h post intraperitoneal inoculation of approximately 10 7 colony-forming unit (cfu) per fish where bloody ascites, increased melanomacrophage centres but no granulomas were observed 6 .…”