Histologic, immunohistochemical, microbiological, molecular biological and ultrastructural characterization of pulmonary tularemia

Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble those of other airways infections. Recently, a case of pulmonary tularemia was diagnosed at Tufts Medical Center. The purpose of the current re...

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Published inPathology, research and practice Vol. 207; no. 1; pp. 63 - 66
Main Authors Navarro, Paula, Garcia-Moliner, Maria L., McMahon, James H., Telford, Sam R., Zoukhri, Driss, Alroy, Joseph
Format Journal Article
LanguageEnglish
Published Germany Elsevier GmbH 01.01.2011
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Abstract Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble those of other airways infections. Recently, a case of pulmonary tularemia was diagnosed at Tufts Medical Center. The purpose of the current report is to document the utility of applying several diagnostic tools, including immunohistochemistry, electron microscopy, microbiology and molecular biology in confirming the diagnosis of pulmonary tularemia, particularly in convalescing cases (up to 3 weeks postpresentation) and after antibiotic therapy. Our study demonstrates the usefulness of microbiological studies followed by morphological evaluation and the limitation of the molecular biology analysis of posttherapy samples.
AbstractList Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble those of other airways infections. Recently, a case of pulmonary tularemia was diagnosed at Tufts Medical Center. The purpose of the current report is to document the utility of applying several diagnostic tools, including immunohistochemistry, electron microscopy, microbiology and molecular biology in confirming the diagnosis of pulmonary tularemia, particularly in convalescing cases (up to 3 weeks postpresentation) and after antibiotic therapy. Our study demonstrates the usefulness of microbiological studies followed by morphological evaluation and the limitation of the molecular biology analysis of posttherapy samples.
Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble those of other airways infections. Recently, a case of pulmonary tularemia was diagnosed at Tufts Medical Center. The purpose of the current report is to document the utility of applying several diagnostic tools, including immunohistochemistry, electron microscopy, microbiology and molecular biology in confirming the diagnosis of pulmonary tularemia, particularly in convalescing cases (up to 3 weeks postpresentation) and after antibiotic therapy. Our study demonstrates the usefulness of microbiological studies followed by morphological evaluation and the limitation of the molecular biology analysis of posttherapy samples.
Author Zoukhri, Driss
Navarro, Paula
Telford, Sam R.
Alroy, Joseph
McMahon, James H.
Garcia-Moliner, Maria L.
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crossref_primary_10_1371_journal_pone_0108864
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10.1183/09031936.03.00088903
10.1097/00005792-198507000-00006
10.1177/104063870201400213
10.4269/ajtmh.1996.54.364
10.1073/pnas.0601838103
10.1196/annals.1409.013
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Keywords Microbiology
Molecular biology
Morphology
Tularemia
Language English
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References Guarner, Geer, Bartlett, Chu, Shieh, Zaki (bib0045) 1999; 7
Evans, Gregory, Schaffner, McGee (bib0030) 1985; 64
Staak, Schwarzkopf, Behn, Hommel, Hlinak, Schade, Erhard (bib0065) 2000
Matyas, Nieder, Telford (bib0055) 2007; 1105
Tarnvik, Berglund (bib0070) 2003; 21
Baskerville, Hambleton (bib0005) 1976; 57
Checroun, Wehrly, Fischer, Hayes, Celli (bib0015) 2007; 103
Dennis (bib0025) 2004
Fulop, Leslie, Titball (bib0040) 1996; 54
DeBey, Anderws, Chard-Bergstrom, Cox (bib0020) 2002; 14
Miller, Bates (bib0060) 1969; 99
Eyzaguirre, Walker, Zaki (bib0035) 2006
Baskerville, Hambleton, Dowsett (bib0010) 1978; 59
Kuhn (bib0050) 1988
Travis, Colby, Koss, Rosand-de-Christenson, Muller, King (bib0075) 2002
Kuhn (10.1016/j.prp.2010.07.002_bib0050) 1988
Checroun (10.1016/j.prp.2010.07.002_bib0015) 2007; 103
Fulop (10.1016/j.prp.2010.07.002_bib0040) 1996; 54
Travis (10.1016/j.prp.2010.07.002_bib0075) 2002
Eyzaguirre (10.1016/j.prp.2010.07.002_bib0035) 2006
Guarner (10.1016/j.prp.2010.07.002_bib0045) 1999; 7
Baskerville (10.1016/j.prp.2010.07.002_bib0005) 1976; 57
Dennis (10.1016/j.prp.2010.07.002_bib0025) 2004
Staak (10.1016/j.prp.2010.07.002_bib0065) 2000
DeBey (10.1016/j.prp.2010.07.002_bib0020) 2002; 14
Matyas (10.1016/j.prp.2010.07.002_bib0055) 2007; 1105
Baskerville (10.1016/j.prp.2010.07.002_bib0010) 1978; 59
Evans (10.1016/j.prp.2010.07.002_bib0030) 1985; 64
Miller (10.1016/j.prp.2010.07.002_bib0060) 1969; 99
Tarnvik (10.1016/j.prp.2010.07.002_bib0070) 2003; 21
References_xml – volume: 21
  start-page: 361
  year: 2003
  end-page: 373
  ident: bib0070
  article-title: Tularemia
  publication-title: Eur. Respir. J.
  contributor:
    fullname: Berglund
– volume: 59
  start-page: 615
  year: 1978
  end-page: 623
  ident: bib0010
  article-title: The pathology of untreated and antibiotic-treated experimental tularemia in monkeys
  publication-title: Br. J. Exp. Pathol.
  contributor:
    fullname: Dowsett
– volume: 14
  start-page: 162
  year: 2002
  end-page: 164
  ident: bib0020
  article-title: Immunohistochemical demonstration of
  publication-title: J. Vet. Diagn. Invest.
  contributor:
    fullname: Cox
– year: 2000
  ident: bib0065
  publication-title: Isolation of IGY from Yolk. PP65-107 in Chicken Egg Yolk Antibodies, Production, and Application
  contributor:
    fullname: Erhard
– volume: 1105
  start-page: 351
  year: 2007
  end-page: 377
  ident: bib0055
  article-title: Pneumonic tularemia on Martha's Vineyard: clinical, epidemiologic and ecological characteristics
  publication-title: Ann. N.Y. Acad. Sci.
  contributor:
    fullname: Telford
– volume: 103
  start-page: 14578
  year: 2007
  end-page: 14583
  ident: bib0015
  article-title: Autophagy-mediated reentry of
  publication-title: Proc. Natl. Acad. Sci.
  contributor:
    fullname: Celli
– start-page: 55
  year: 2006
  end-page: 56
  ident: bib0035
  article-title: Tularemia
  publication-title: Diagnostic Immunohistochemistry
  contributor:
    fullname: Zaki
– year: 2002
  ident: bib0075
  article-title:
  publication-title: Atlas of Nontumor Pathology, Non-neoplastic Disorders of the Lower Respiratory Tract
  contributor:
    fullname: King
– volume: 64
  start-page: 251
  year: 1985
  end-page: 269
  ident: bib0030
  article-title: Tularemia: a 30-year experience with 88 cases
  publication-title: Medicine
  contributor:
    fullname: McGee
– volume: 57
  start-page: 339
  year: 1976
  end-page: 347
  ident: bib0005
  article-title: Pathogenesis and pathology of respiratory Tularemia in the rabbit
  publication-title: Br. J. Exp. Pathol.
  contributor:
    fullname: Hambleton
– volume: 54
  start-page: 364
  year: 1996
  end-page: 366
  ident: bib0040
  article-title: A rapid, highly sensitive method for detection of
  publication-title: Am. J. Trop. Med. Hyg.
  contributor:
    fullname: Titball
– start-page: 207
  year: 1988
  end-page: 209
  ident: bib0050
  article-title: Tularemia
  publication-title: Pathology of the Lung
  contributor:
    fullname: Kuhn
– start-page: 1446
  year: 2004
  end-page: 1451
  ident: bib0025
  article-title: Tularemia
  publication-title: Infectious Diseases
  contributor:
    fullname: Dennis
– volume: 99
  start-page: 31
  year: 1969
  end-page: 41
  ident: bib0060
  article-title: Pleuropulmonary tularemia. A review of 29 patients
  publication-title: Am. Rev. Dis.
  contributor:
    fullname: Bates
– volume: 7
  start-page: 122
  year: 1999
  end-page: 126
  ident: bib0045
  article-title: Immunohistochemical detection of
  publication-title: Appl. Immunohistochem. Mol. Morphol.
  contributor:
    fullname: Zaki
– start-page: 207
  year: 1988
  ident: 10.1016/j.prp.2010.07.002_bib0050
  article-title: Tularemia
  contributor:
    fullname: Kuhn
– year: 2002
  ident: 10.1016/j.prp.2010.07.002_bib0075
  article-title: Francisella tularensis
  contributor:
    fullname: Travis
– volume: 7
  start-page: 122
  year: 1999
  ident: 10.1016/j.prp.2010.07.002_bib0045
  article-title: Immunohistochemical detection of Francisella tularensis in formalin-fixed paraffin-embedded tissue
  publication-title: Appl. Immunohistochem. Mol. Morphol.
  doi: 10.1097/00022744-199906000-00004
  contributor:
    fullname: Guarner
– start-page: 55
  year: 2006
  ident: 10.1016/j.prp.2010.07.002_bib0035
  article-title: Tularemia
  contributor:
    fullname: Eyzaguirre
– volume: 57
  start-page: 339
  year: 1976
  ident: 10.1016/j.prp.2010.07.002_bib0005
  article-title: Pathogenesis and pathology of respiratory Tularemia in the rabbit
  publication-title: Br. J. Exp. Pathol.
  contributor:
    fullname: Baskerville
– start-page: 1446
  year: 2004
  ident: 10.1016/j.prp.2010.07.002_bib0025
  article-title: Tularemia
  contributor:
    fullname: Dennis
– volume: 99
  start-page: 31
  year: 1969
  ident: 10.1016/j.prp.2010.07.002_bib0060
  article-title: Pleuropulmonary tularemia. A review of 29 patients
  publication-title: Am. Rev. Dis.
  contributor:
    fullname: Miller
– volume: 21
  start-page: 361
  year: 2003
  ident: 10.1016/j.prp.2010.07.002_bib0070
  article-title: Tularemia
  publication-title: Eur. Respir. J.
  doi: 10.1183/09031936.03.00088903
  contributor:
    fullname: Tarnvik
– volume: 64
  start-page: 251
  year: 1985
  ident: 10.1016/j.prp.2010.07.002_bib0030
  article-title: Tularemia: a 30-year experience with 88 cases
  publication-title: Medicine
  doi: 10.1097/00005792-198507000-00006
  contributor:
    fullname: Evans
– year: 2000
  ident: 10.1016/j.prp.2010.07.002_bib0065
  contributor:
    fullname: Staak
– volume: 59
  start-page: 615
  year: 1978
  ident: 10.1016/j.prp.2010.07.002_bib0010
  article-title: The pathology of untreated and antibiotic-treated experimental tularemia in monkeys
  publication-title: Br. J. Exp. Pathol.
  contributor:
    fullname: Baskerville
– volume: 14
  start-page: 162
  year: 2002
  ident: 10.1016/j.prp.2010.07.002_bib0020
  article-title: Immunohistochemical demonstration of Francisella tularensis in lesions of cats with tularemia
  publication-title: J. Vet. Diagn. Invest.
  doi: 10.1177/104063870201400213
  contributor:
    fullname: DeBey
– volume: 54
  start-page: 364
  year: 1996
  ident: 10.1016/j.prp.2010.07.002_bib0040
  article-title: A rapid, highly sensitive method for detection of Francisella tularensis in clinical samples using the polymerase chain reaction
  publication-title: Am. J. Trop. Med. Hyg.
  doi: 10.4269/ajtmh.1996.54.364
  contributor:
    fullname: Fulop
– volume: 103
  start-page: 14578
  year: 2007
  ident: 10.1016/j.prp.2010.07.002_bib0015
  article-title: Autophagy-mediated reentry of Francisella tularensis into the endocytic compartment after cytoplasmic replication
  publication-title: Proc. Natl. Acad. Sci.
  doi: 10.1073/pnas.0601838103
  contributor:
    fullname: Checroun
– volume: 1105
  start-page: 351
  year: 2007
  ident: 10.1016/j.prp.2010.07.002_bib0055
  article-title: Pneumonic tularemia on Martha's Vineyard: clinical, epidemiologic and ecological characteristics
  publication-title: Ann. N.Y. Acad. Sci.
  doi: 10.1196/annals.1409.013
  contributor:
    fullname: Matyas
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Snippet Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble...
Tularemia is a rare zoonotic disease caused by Francisella tularensis, a Gram-negative bacteria. The clinical manifestations of pulmonary tularemia resemble...
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SubjectTerms Anti-Bacterial Agents - therapeutic use
Antigens, Bacterial - analysis
Drainage
Francisella tularensis - genetics
Francisella tularensis - immunology
Francisella tularensis - pathogenicity
Humans
Immunohistochemistry
Lung - diagnostic imaging
Lung - microbiology
Lung - pathology
Lung - ultrastructure
Lung Diseases - diagnosis
Lung Diseases - drug therapy
Lung Diseases - microbiology
Lung Diseases - surgery
Male
Microbiology
Microscopy, Electron
Molecular biology
Morphology
Pleural Effusion - complications
Pleural Effusion - therapy
Polymerase Chain Reaction
Tomography, X-Ray Computed
Treatment Outcome
Tularemia
Tularemia - diagnosis
Tularemia - drug therapy
Tularemia - surgery
Young Adult
Title Histologic, immunohistochemical, microbiological, molecular biological and ultrastructural characterization of pulmonary tularemia
URI https://dx.doi.org/10.1016/j.prp.2010.07.002
https://www.ncbi.nlm.nih.gov/pubmed/20709464
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