Christian A. Olivo, MD; Claire Dysart, PharmD; Javeria Haque, MD; Cristina Olivo, MD; Sami El-Dalati, MD; Nathan Gundacker, MD
WMJ. 2019;118(4):196-198.
ABSTRACT
Introduction: Francisella tularensis subspecies holarctica is the most common cause of tularemia in Europe and Japan. Tularemia presents in clinical syndromes, usually as ulceroglandular and glandular syndrome. This entity rarely causes endocarditis. In the United States, only 1 case of a native valve infectious endocarditis has been described to date.
Case Presentation: In this article, we report a case of a patient with several weeks of fevers, night sweats, and myalgias who was diagnosed with prosthetic valve infectious endocarditis secondary to F tularensis subspecies holarctica.
Discussion: Four previous case reports of F tularensis endocarditis have been reported worldwide, with this being the first case of prosthetic valve endocarditis. Antibiotic therapy alone has provided effective treatment in all reported cases of endocarditis.
Conclusion: Infective endocarditis caused by F tularensis is an important entity for physicians to understand in areas of endemicity, especially in cases of culture-negative endocarditis.
Author Affiliations: Department of Medicine, Mount Sinai St. Luke’s – West Hospital, New York City, NY (Olivo CA); Zablocki VA Medical Center, Milwaukee, Wis (Dysart); Department of Medicine, Division of Infectious Diseases, Medical College of Wisconsin, Zablocki VA Medical Center, Milwaukee, Wis (Haque, Gundacker); Gorgas Memorial Institute for Health Studies, Panama City, Panama (Olivo C); Department of Medicine, Division of Infectious Diseases, University of Michigan (El-Dalati).
Corresponding Author: Nathan D. Gundacker, MD, Department of Medicine, Division of Infectious Diseases, Medical College of Wisconsin, Zablocki VA Medical Center, 8701 Watertown Plank Rd, Milwaukee, WI 53226; email ngundacker@mcw.edu.
Financial Disclosures: None declared.
Funding/Support: None declared.
Share WMJ