- Background: Tularemia is caused by Francisella tularensis and can occasionally establish foodborne transmission.
Methods: Patients were identified by active case detection through contact with the treating physicians and consent for publication was obtained. Clinical data were accumulated through a review of the patient charts. Serology, culture, and PCR methods were performed for confirmation of the diagnosis.
Case cluster: A 46-year-old patient was hospitalised in the University Hospital Frankfurt (a tertiary care hospital) for pharyngitis and cervical lymphadenitis with abscess. A diagnosis of tularemia was made serologically, but treatment with ciprofloxacin initially failed. F. tularensis was detected in pus from the lymph node using a specific real-time PCR. The use of RD1 PCR led to the identification of the subspecies holarctica. Antibiotic therapy with high-dose ciprofloxacin and gentamicin was administered and was subsequently changed to ciprofloxacin and rifampicin. During a must-tasting, five other individuals became infected with tularemia by ingestion of contaminated must. All patients required treatment durations of more than 14 days.
Conclusions: Mechanically harvested agricultural products, such as wine must, can be a source of infection, probably due to contamination with animal carcasses. The clinical course of tularemia can be complicated and prolonged and requires differentiated antibiotic treatment.
MetadatenAuthor: | Nils WetzsteinORCiDGND, Iris Kärcher, Klaus P. Küpper-Tetzel, Gerrit KannGND, Michael HogardtORCiDGND, Katalin Jozsa, Daniela Jacob, Roland Grunow, Gudrun Just-Nübling, Timo WolfORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-502692 |
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DOI: | https://doi.org/10.1016/j.ijid.2019.04.031 |
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ISSN: | 1878-3511 |
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ISSN: | 1201-9712 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/31071480 |
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Parent Title (English): | International journal of infectious diseases |
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Publisher: | Elsevier |
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Place of publication: | Amsterdam [u. a.] |
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Contributor(s): | Eskild Petersen |
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Document Type: | Article |
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Language: | English |
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Year of Completion: | 2019 |
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Date of first Publication: | 2019/05/06 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2019/06/13 |
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Tag: | Francisella tularensis; Francisella tularensis subspecies holarctica; Tularemia; Zoonosis |
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Volume: | 84 |
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Page Number: | 5 |
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First Page: | 116 |
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Last Page: | 120 |
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Note: | © 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/). |
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HeBIS-PPN: | 450770699 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Open-Access-Publikationsfonds: | Medizin |
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Licence (German): | Creative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0 |
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