Water- and airborne Francisella tularensis biovar palaearctica isolated from human blood.

The isolation of Francisella tularensis from human blood is extremely rare in Europe. We here describe two cases of septicemia caused by F. tularensis biovar palaearctica, where the causative bacterium was isolated from blood. One of our patients had ingested contaminated water; the other was probably infected by inhalation of contaminated dust. The isolation of the causative organism was essential for initiating the appropriate antibiotic treatment, which led to a rapid improvement. Since the responsive agent rarely is isolated from tularemia patients, blood cultures should be drawn more often in order to improve the diagnostic procedures.