Confirmed Case of Longstanding Respiratory Francisella tularensis holarctica Infection: Nebraska, 2022

Rachael Birn; Jeff Hamik; Lana Dayne; Justin Frederick; Amanda Bartling; Peter C Iwen; Adam Wells; Matthew Donahue

doi:10.1093/cid/ciad669

Confirmed Case of Longstanding Respiratory Francisella tularensis holarctica Infection: Nebraska, 2022

Clin Infect Dis. 2024 Jan 31;78(Suppl 1):S64-S66. doi: 10.1093/cid/ciad669.

Authors

Rachael Birn^{1

2

3}, Jeff Hamik^{1

4}, Lana Dayne⁵, Justin Frederick⁵, Amanda Bartling⁶, Peter C Iwen⁶, Adam Wells^{7

8}, Matthew Donahue¹

Affiliations

¹ Epidemiology Unit, Nebraska Department of Health and Human Services, Lincoln, Nebraska, USA.
² Applied Epidemiology Fellow, Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA.
³ Water, Climate and Health Program, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁴ Department of Educational Psychology, University of Nebraska, Lincoln, Nebraska, USA.
⁵ Communicable Disease Epidemiology Section, Douglas County Health Department, Omaha, Nebraska, USA.
⁶ Department of Pathology and Microbiology, Nebraska Public Health Laboratory, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁷ Pulmonary and Critical Care Medicine Section, Nebraska Methodist Hospital, Omaha, Nebraska, USA.
⁸ Respiratory Care Program, Nebraska Methodist College, Omaha, Nebraska, USA.

Abstract

A male patient with distant history of extensive rabbit contact and pulmonary nodules for 6 years developed empyema. Francisella tularensis holarctica was isolated from thoracentesis fluid. Retrospective immunohistochemical examination of a pulmonary nodule, biopsied 3 years prior, was immunoreactive for F. tularensis. These findings suggest the potential for chronic tularemia.

Keywords: Francisella tularensis holarctica; chronic tularemia; respiratory.

MeSH terms

Animals
Francisella tularensis*
Humans
Male
Multiple Pulmonary Nodules*
Nebraska
Rabbits
Retrospective Studies
Tularemia* / diagnosis