摘要
Tularemia, caused by the bacterium Francisella tularensis, is an infrequent zoonotic infection, well known in immunocompetent (but poorly described in immunocompromised) patients. Although there is no clear literature data about the specific characteristics of this disease in immunocompromised patients, clinical reports seem to describe a different presentation of tularemia in these patients. Moreover, atypical clinical presentations added to the fastidiousness of pathogen identification seem to be responsible for a delayed diagnosis, leading to a” loss of chance” for immunocompromised patients. In this article, we first provide an overview of the host immune responses to Francisella infections and discuss how immunosuppressive therapies or diseases can lead to a higher susceptibility to tularemia. Then, we describe the particular clinical patterns of tularemia in immunocompromised patients from the literature. We also provide hints of an alternative diagnostic strategy regarding these patients. In conclusion, tularemia should be considered in immunocompromised patients presenting pulmonary symptoms or unexplained fever. Molecular techniques on pathological tissues might improve diagnosis with faster results.
摘要译文
由细菌Francisella Tularensis引起的尖端血症是一种罕见的动物区感染，众所周知的免疫活性剂（但在免疫功能度计中均未描述）患者。虽然没有关于这种疾病的特定特征的明确文献数据，但临床报告似乎描述了这些患者的不同术语的不同介绍。此外，添加到病原体鉴定的严密性的非典型临床介绍似乎是延迟诊断的原因，导致免疫疗效患者的“机会损失”。在本文中，我们首先概述了对Francisella感染的宿主免疫反应，并讨论了免疫抑制疗法或疾病如何导致对Tularemia的更高易感性。然后，我们描述了从文献中的免疫功能性患者中的特定临床模式。我们还提供了有关这些患者的替代诊断策略的提示。总之，在免疫血症患者中应考虑患有肺症状或未解释的发烧的颅脑。病理组织的分子技术可能改善较快的结果诊断。
Olivier Bahuaud;Cécile Le Brun;Adrien Lemaignen. Host Immunity and Francisella tularensis: A Review of Tularemia in Immunocompromised Patients[J]. Microorganisms, 2021,9(12): 2539