Emerg Infect Dis. 2023 Jun;29(6):1118-1126. doi: 10.3201/eid2906.221395.
Tularemia is a zoonotic infection caused by Francisella tularensis. Its most typical manifestations in humans are ulceroglandular and glandular; infections in prosthetic joints are rare. We report 3 cases of F. tularensis subspecies holarctica-related prosthetic joint infection that occurred in France during 2016-2019. We also reviewed relevant literature and found only 5 other cases of Francisella-related prosthetic joint infections worldwide, which we summarized. Among those 8 patients, clinical symptoms appeared 7 days to 19 years after the joint placement and were nonspecific to tularemia. Although positive cultures are typically obtained in only 10% of tularemia cases, strains grew in all 8 of the patients. F. tularensis was initially identified in 2 patients by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; molecular methods were used for 6 patients. Surgical treatment in conjunction with long-term antimicrobial treatment resulted in favorable outcomes; no relapses were seen after 6 months of follow-up.
兔热病是由土拉弗朗西斯菌引起的人畜共患感染。其在人类中最典型的表现为溃疡腺型和腺型；人工关节感染较为罕见。我们报告了法国在 2016 年至 2019 年间发生的 3 例与土拉弗朗西斯菌亚种 holarctica 相关的人工关节感染病例。我们还回顾了相关文献，发现全球仅有 5 例其他与弗朗西斯菌相关的人工关节感染病例，并对其进行了总结。在这 8 名患者中，关节植入后 7 天至 19 年出现临床症状，且均无特异性表现。尽管土拉弗朗西斯菌感染病例中通常仅 10%可培养阳性，但 8 例患者的菌株均生长。2 例患者最初通过基质辅助激光解吸电离飞行时间质谱鉴定为土拉弗朗西斯菌；6 例患者采用分子方法鉴定。联合手术治疗和长期抗菌治疗后取得了良好的效果；在 6 个月的随访后未见复发。
