Tularemia: an experience of 13 cases including a rare myocarditis in a referral center in Eastern Switzerland (Central Europe) and a review of the literature

Frischknecht, Manuel; Meier, Angelina; Mani, Bernhard; Joerg, Lucas; Kim, Olaf Chan-Hi; Boggian, Katia; Strahm, Carol

doi:10.1007/s15010-019-01269-7

Cited by 21 publications

(31 citation statements)

References 48 publications

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“…The heterogeneity of symptoms in tularemia is largely explained by mode of transmission [ 4 , 5 ]. But where the first case manifested with classic tick-mediated symptoms (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…skin and lymph node involvement) [ 4 ], the second case displayed systemic symptoms without skin infection. F. tularensis can spread hematogenous and systemic disease can be a complication to all forms of tularemia, however pneumonia is typically related to the inhalation of aerosols [ 2 , 9 ] and as the patient had a vacation home in a high-risk area, she could have inhaled aerosols for example in connection to lawn moving [ 5 ]. Myocarditis has been reported as a complication to tularemia in at least one other case with tick bite as point of entry [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Two subspecies are known to be the main causes of human disease; F. tularensis holartica, is prominent in Europe and less virulent than F. tularensis tularensis which is mainly found in North America [ 1 , 3 ]. Transmission is commonly mediated through arthropod bites, by direct contact with infected animals, ingestion of contaminated water or meat or by inhalation or conjunctival exposure of aerosols [ 2 , 4 , 5 ]. Early clinical presentation usually includes flu-like symptoms such as fever, myalgia, arthralgia and headache, but further symptoms depend on bacterial virulence, host immune status and on the route of transmission.…”

Section: Introductionmentioning

confidence: 99%

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The clinical spectrum of tularemia—Two cases

Ørbæk

Lebech

Helleberg

2020

IDCases

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We report two cases of tularemia with different clinical manifestations, both suspected of tick-borne transmission and with near-complete remission of all symptoms within 3 months after antimicrobial treatment. The first patient presented with a classical ulceroglandular manifestation; general malaise, an ulcer and lymphadenopathy, occurring two weeks after a tick bite. Diagnosis was established by polymerase chain reaction of a skin biopsy from the ulcer. The second patient presented with a rare systemic manifestation including bacteremia and myocarditis resulting in severe clinical heart failure, pulmonary edema and secondary kidney failure. Previous tick bites were elucidated after the bacteremia was discovered. The cases underscore the heterogeneity of manifestations, the diagnostic approach and the importance of thorough medical history including recent exposures especially in cases with infection of unknown origin.

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“…The heterogeneity of symptoms in tularemia is largely explained by mode of transmission [ 4 , 5 ]. But where the first case manifested with classic tick-mediated symptoms (i.e.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The clinical spectrum of tularemia—Two cases

Ørbæk

Lebech

Helleberg

2020

IDCases

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“…1 Additionally, transmission has been reported after exposure from domesticated dogs and cats. 8,9 Large outbreaks are not characteristic of this zoonosis.…”

Section: Video Highlightsmentioning

confidence: 98%

“…Finally, three case reports to date detail cases of myocarditis caused by F tularensis. 8 This disease manifestation appears to be clinically unrecognized before the first description of tularemia-associated myocarditis, in 2010.…”

Section: Video Highlightsmentioning

confidence: 99%

Tick-Borne Illness and Infective Endocarditis: A Rare Case of Tularemia

Kaeppler

Kapoor

Shah

et al. 2020

CASE

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Unusual pediatric lung infections: imaging findings

Plut,

Winant,

Mahomed

et al. 2023

Pediatr Radiol

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Pediatric lung infections continue to be a leading cause of pediatric morbidity and mortality. Although both pediatric and general radiologists are familiar with typical lung infections and their imaging findings in children, relatively rare lung infections continue to present a diagnostic challenge. In addition, the advances in radiological imaging and emergence of several new lung infections in recent years facilitated the need for up-to-date knowledge on this topic. In this review article, we discuss the imaging findings of pediatric lung infections caused by unusual/uncommon and new pathogens. We review the epidemiological, clinical, and radiological imaging findings of viral (coronavirus disease 2019, Middle East respiratory syndrome, bird flu), bacterial (Streptococcus anginosus, Francisella tularensis, Chlamydia psittaci), and parasitic lung infections (echinococcosis, paragonimiasis, amoebiasis). Additional disorders whose clinical course and imaging findings may mimic lung infections in children (hypersensitivity pneumonitis, pulmonary hemorrhage, eosinophilic pneumonia) are also presented, to aid in differential diagnosis. As the clinical presentation of children with new and unusual lung infections is often non-specific, imaging evaluation plays an important role in initial detection, follow-up for disease progression, and assessment of potential complications. Graphical Abstract

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Tularemia: an experience of 13 cases including a rare myocarditis in a referral center in Eastern Switzerland (Central Europe) and a review of the literature

Cited by 21 publications

References 48 publications

The clinical spectrum of tularemia—Two cases

The clinical spectrum of tularemia—Two cases

Tick-Borne Illness and Infective Endocarditis: A Rare Case of Tularemia

Unusual pediatric lung infections: imaging findings

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