Tularemia Proximal Interphalangeal Joint Septic Arthritis

Clary, Steven J.; Brubacher, Jacob; Kubát, R

doi:10.2106/jbjs.cc.22.00287

Cited by 2 publications

(2 citation statements)

References 12 publications

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“… Clary et al (2022) reported a finger interphalangeal joint arthritis caused by Francisella tularensis inoculated through a cat bite. The patient was cured after receiving gentamicin for 4 weeks.…”

Section: Tularemia Treatment In Humansmentioning

confidence: 99%

“…F. tularensis was isolated from the aortic and periaortic tissues. He was cured after replacing the aortic graft and gentamicin plus ciprofloxacin treatment for 2 weeks then ciprofloxacin for 10 weeks 6.4.5 Prosthetic joint infections Clary et al (2022) reported a finger interphalangeal joint arthritis caused by Francisella tularensis inoculated through a cat bite. The patient was cured after receiving gentamicin for 4 weeks.…”

Section: Endocarditis and Aortic Infectionsmentioning

confidence: 99%

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Tularemia treatment: experimental and clinical data

Maurin,

Pondérand,

Hennebique

et al. 2024

Front. Microbiol.

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Tularemia is a zoonosis caused by the Gram negative, facultative intracellular bacterium Francisella tularensis. This disease has multiple clinical presentations according to the route of infection, the virulence of the infecting bacterial strain, and the underlying medical condition of infected persons. Systemic infections (e.g., pneumonic and typhoidal form) and complications are rare but may be life threatening. Most people suffer from local infection (e.g., skin ulcer, conjunctivitis, or pharyngitis) with regional lymphadenopathy, which evolve to suppuration in about 30% of patients and a chronic course of infection. Current treatment recommendations have been established to manage acute infections in the context of a biological threat and do not consider the great variability of clinical situations. This review summarizes literature data on antibiotic efficacy against F. tularensis in vitro, in animal models, and in humans. Empirical treatment with beta-lactams, most macrolides, or anti-tuberculosis agents is usually ineffective. The aminoglycosides gentamicin and streptomycin remain the gold standard for severe infections, and the fluoroquinolones and doxycycline for infections of mild severity, although current data indicate the former are usually more effective. However, the antibiotic treatments reported in the literature are highly variable in their composition and duration depending on the clinical manifestations, the age and health status of the patient, the presence of complications, and the evolution of the disease. Many patients received several antibiotics in combination or successively. Whatever the antibiotic treatment administered, variable but high rates of treatment failures and relapses are still observed, especially in patients treated more then 2–3 weeks after disease onset. In these patients, surgical treatment is often necessary for cure, including drainage or removal of suppurative lymph nodes or other infectious foci. It is currently difficult to establish therapeutic recommendations, particularly due to lack of comparative randomized studies. However, we have attempted to summarize current knowledge through proposals for improving tularemia treatment which will have to be discussed by a group of experts. A major factor in improving the prognosis of patients with tularemia is the early administration of appropriate treatment, which requires better medical knowledge and diagnostic strategy of this disease.

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Section: Tularemia Treatment In Humansmentioning

confidence: 99%

Section: Endocarditis and Aortic Infectionsmentioning

confidence: 99%

Tularemia treatment: experimental and clinical data

Maurin,

Pondérand,

Hennebique

et al. 2024

Front. Microbiol.

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Francisella tularensis Bone and Joint Infections: United States, 2004–2023

Beeson,

Baker,

Dell

et al. 2024

Clinical Infectious Diseases

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Tularemia is caused by the highly infectious bacterium Francisella tularensis, which is recognized as a Tier 1 bioterrorism agent. Tularemia has a range of recognized clinical manifestations, but fewer than 20 bone or joint infections from 6 countries have been reported in the literature to date. This series includes 13 cases of F. tularensis septic arthritis or osteomyelitis in the United States during 2004–2023 and describes exposures, clinical presentation, diagnosis, and outcomes for this rare but severe form of tularemia. Clinicians should consider F. tularensis in patients with compatible exposures or a history of joint replacement or immunosuppression.

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Tularemia Proximal Interphalangeal Joint Septic Arthritis

Cited by 2 publications

References 12 publications

Tularemia treatment: experimental and clinical data

Tularemia treatment: experimental and clinical data

Francisella tularensis Bone and Joint Infections: United States, 2004–2023

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