警惕土拉弗朗西斯菌：峡谷徒步旅行后的乳突炎病例。
Keep an Ear Out for Francisella tularensis: Otomastoiditis Cases after Canyoneering.
机构信息
Infectious Diseases Department, Hospices civils de Lyon , Lyon , France.
ENT Department, Hospices civils de Lyon , Lyon , France.
出版信息
Front Med (Lausanne). 2016 Mar 3;3:9. doi: 10.3389/fmed.2016.00009. eCollection 2016.
Abstract
We report here three unusual cases of otomastoiditis due to Francisella tularensis, complicated by cervical abscesses and persistent hearing loss, plus facial paralysis for one patient. Intriguingly, the three patients had practiced canyoneering independently in the same French river, between 2009 and 2014, several days before clinical symptoms onset. The results point out that fresh water exposure may be a potential contamination route for tularemia. Besides, due to the frequent complications and sequelae, we believe that F. tularensis should be considered as a possible etiology in case of otitis media, failure of the conventional antibiotic treatment, and suspicious exposure of the bacteria.
摘要
我们在此报告 3 例罕见的土拉弗朗西斯菌耳源性中耳炎病例，均并发颈脓肿和持续性听力损失，其中 1 例患者还伴有面瘫。有趣的是，这 3 名患者均于 2009 年至 2014 年期间在法国的同一条河流中进行独立的溪降运动，在出现临床症状前数天。结果表明，淡水暴露可能是土拉弗朗西斯菌感染的潜在途径。此外，由于频繁出现并发症和后遗症，我们认为，在出现中耳炎、常规抗生素治疗失败和疑似细菌暴露的情况下，应考虑土拉弗朗西斯菌为可能的病因。
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