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#Clinical #Clinique #Legionella #Legionellose #Maladies-infectieuses-et-tropicales #Manifestation #Pneumonia #Pneumonie
Predominant symptoms include fever, cough, and shortness of breath [1-10]. Symptoms typically arise 2 to 10 days after exposure to contaminated water or soil. Fever and fatigue often precede the onset of cough. Rales and/or other signs of consolidation can be present on physical examination. Sputum may be difficult to obtain.
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f Legionella infection".) LEGIONNAIRES' DISEASE (LEGIONELLA PNEUMONIA) Clinical features — Pneumonia caused by Legionella is clinically and radiographically similar to other forms of pneumonia. <span>Predominant symptoms include fever, cough, and shortness of breath [1-10]. Symptoms typically arise 2 to 10 days after exposure to contaminated water or soil. Fever and fatigue often precede the onset of cough. Rales and/or other signs of consolidation can be present on physical examination. Sputum may be difficult to obtain. Radiographic findings are varied and nonspecific; however, the most common findings are patchy unilobar infiltrates, which can progress to consolidations [11-13]. Although no clinical f




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As to methods, there may be a million and then some, but principles are few. The man who grasps principles can successfully select his own methods. The man who tries methods, ignoring principles, is sure to have trouble. —RALPH WALDO EMERSON, ESSAYIST AND POET
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Question
Quelles sont les trois espèces de Francisella majoritairement impliquées en pathologie humaine ?
Answer
  • Francisella tularensis
  • Francisella novicida
  • Francisella philomiragia

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Three species of the genus Francisella are associated with human disease: Francisella tularensis, Francisella novicida, and Francisella philomiragia

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Question
Quel type de comorbidité prédispose aux infections à Francisella novicida et philomiragia ?
Answer
Immunodépression

"F. novicida and F. philomiragia [...] have a predilection for patients with immunologic deficiencies (i.e., chronic granulomatous disease, myeloproliferative diseases)" - Medical Microbiology

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F. novicida and F. philomiragia are uncommon, opportunistic pathogens that have a predilection for patients with immunologic deficiencies (i.e., chronic granulomatous disease, myeloproliferative diseases)

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Question
Quelles sont les caractéristiques morphologiques de F. tularensis à la coloration de Gram ?
[unknown IMAGE 7676686109964]
Answer

  • Gram négatif
  • Cocobacille
  • Petit
  • Coloration faible

"F. tularensis is a very small (0.2 × 0.2 to 0.7 μm), faintly staining, gram-negative coccobacillus" - Medical Microbiology


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F. tularensis is a very small (0.2 × 0.2 to 0.7 μm), faintly staining, gram-negative coccobacillus (Figure 29-4).

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Question
De quel acide aminé la plupart des souches de F. tularensis ont-elles besoin pour pousser in vitro ?
Answer

Cystéine

"most strains require cysteine for growth" - Medical Microbiology


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is nonmotile, has a thin lipid capsule, and has fastidious growth requirements (i.e., most strains require cysteine for growth). It is strictly aerobic and requires 3 or more days before growth is detected in culture

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Question
Combien de jours sont généralement nécessaires avant de détecter la présence de F. tularensis en culture in vitro ?
Answer

3 jours

"requires 3 or more days before growth is detected in culture" - Medical Microbiology


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is nonmotile, has a thin lipid capsule, and has fastidious growth requirements (i.e., most strains require cysteine for growth). It is strictly aerobic and requires 3 or more days before growth is detected in culture

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Question
Comment classifier F. tularensis au regard de ses besoins en oxygène ?
Answer

Aérobie strict

"It is strictly aerobic" - Medical Microbiology


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is nonmotile, has a thin lipid capsule, and has fastidious growth requirements (i.e., most strains require cysteine for growth). It is strictly aerobic and requires 3 or more days before growth is detected in culture

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Question
Comment qualifier la localisation préférentielle de F. tularensis au cours de l'infection ?
Answer

Intracellulaire facultatif

"facultative intracellular pathogen" - Medical Microbiology


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n. Specific T-cell immunity is required for activation of macrophages for intracellular killing in the late stages of disease. B cell–mediated immunity is less important for elimination of this <span>facultative intracellular pathogen <span>

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Question
Citer deux cytokines majeures de la réponse immunitaire innée contre F. tularensis
Answer

  • TNF alpha
  • Interferon gamma

"A strong, innate immune response with production of interferon (IFN)-γ and tumor necrosis factor is important for controlling bacterial replication" - Medical Microbiology


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A strong, innate immune response with production of interferon (IFN)-γ and tumor necrosis factor is important for controlling bacterial replication in macrophages in the early phase of infection. Specific T-cell immunity is required for activation of macrophages for intracellular killing in the late stages of disease. B cell–mediat

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Question
Dans quel type cellulaire se réplique préférentiellement F. tularensis à la phase précoce de l'infection ?
Answer

Macrophages

"bacterial replication in macrophages in the early phase of infection" - Medical Microbiology


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A strong, innate immune response with production of interferon (IFN)-γ and tumor necrosis factor is important for controlling bacterial replication in macrophages in the early phase of infection. Specific T-cell immunity is required for activation of macrophages for intracellular killing in the late stages of disease. B cell–mediated immunity is less important for elimination o

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Question
Quelles sont les deux principales sous-espèces de Francisella du genre tularensis ?
Answer

F. tularensis :

  • subsp. tularensis
  • subsp. holarctica

Medical Microbiology


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F. tularensis subsp. tularensis (type A) is restricted to North America, whereas subsp. holarctica (type B) is endemic throughout the Northern Hemisphere. Type A strains are further subdivided into type A–west, which predominates in the arid region from the Rocky Mountains to the Sierra Nevada Mountains, and type A–east, which occurs in

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Question
Quelle sous-espèce principale de F. tularensis correspond au type A ?
Answer

F. tularensis subsp. tularensis (type A)

Medical Microbiology


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F. tularensis subsp. tularensis (type A) is restricted to North America, whereas subsp. holarctica (type B) is endemic throughout the Northern Hemisphere. Type A strains are further subdivided into type A–west, which predominates in the arid region from the Rocky Mountains to the Sierra Nevada Mountains, and type A–east, which occurs in

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Question
Quelle sous-espèce principale de F. tularensis correspond au type B ?
Answer

F. tularensis subsp. holarctica (type B)

Medical Microbiology


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F. tularensis subsp. tularensis (type A) is restricted to North America, whereas subsp. holarctica (type B) is endemic throughout the Northern Hemisphere. Type A strains are further subdivided into type A–west, which predominates in the arid region from the Rocky Mountains to the Sierra Nevad

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Question
Quelle est la répartition géographique principale des souches de type A de F. tularensis ?
Answer

Amérique du Nord

"F. tularensis subsp. tularensis (type A) is restricted to North America [...]" - Medical Microbiology


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F. tularensis subsp. tularensis (type A) is restricted to North America, whereas subsp. holarctica (type B) is endemic throughout the Northern Hemisphere. Type A strains are further subdivided into type A–west, which predominates in the arid region from the Rocky Mountains to the Sierra Nevada Mountains, and type A–east, which occurs in

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Question
Quelle est la répartition géographique principale des souches de type B de F. tularensis ?
Answer

Hémisphère nord

"[...] subsp. holarctica (type B) is endemic throughout the Northern Hemisphere" - Medical Microbiology


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F. tularensis subsp. tularensis (type A) is restricted to North America, whereas subsp. holarctica (type B) is endemic throughout the Northern Hemisphere. Type A strains are further subdivided into type A–west, which predominates in the arid region from the Rocky Mountains to the Sierra Nevada Mountains, and type A–east, which occurs in

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Question
À quelles espèces animales les infections à F. tularensis de type A sont-elles liées ?
Answer

  • Lagomorphes (lapins, lièvres)
  • Chats

"Type A infections are most commonly associated with exposure to lagomorphs (rabbits, hares) and cats" - Medical Microbiology


Lagomorphe : "Du grec ancien λαγώς, lagôs (« lièvre ») et μορφή, morphê (« forme »)." - Wiktionnaire
https://fr.wiktionary.org/wiki/lagomorphe
Diffèrent des rongeurs par leur denture (deux paires d'incisive en haut, une en bas et absence d'os pénien (baculum) - Wikipedia
https://fr.wikipedia.org/wiki/Lagomorpha


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Type A infections are most commonly associated with exposure to lagomorphs (rabbits, hares) and cats; type B infections are associated with rodents and cats, but not lagomorphs. Infections caused by biting arthropods (e.g., hard ticks [Ixodes, Dermacentor, Amblyomma spp.], deerflies) a

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Question
À quelles espèces animales sont liées les infections à F. tularensis de type B ?
Answer

  • Rongeurs
  • Chats

"[...] type B infections are associated with rodents and cats, but not lagomorphs" - Medical Microbiology


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Type A infections are most commonly associated with exposure to lagomorphs (rabbits, hares) and cats; type B infections are associated with rodents and cats, but not lagomorphs. Infections caused by biting arthropods (e.g., hard ticks [Ixodes, Dermacentor, Amblyomma spp.], deerflies) are more common with type A than with type B strains.

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Question
Quel type de sous-espèce de F. tularensis est plus volontiers associé aux morsures d'arthropodes ?
Answer

Type A (subsp tularensis)

"Infections caused by biting arthropods [...] are more common with type A than with type B strains." - Medical Microbiology


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Type A infections are most commonly associated with exposure to lagomorphs (rabbits, hares) and cats; type B infections are associated with rodents and cats, but not lagomorphs. Infections caused by biting arthropods (e.g., hard ticks [Ixodes, Dermacentor, Amblyomma spp.], deerflies) are more common with type A than with type B strains.

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Question
Citer 3 espèces de tiques dures dont la morsure peut exposer à une infection par F. tularensis
Answer

  • Ixodes spp.
  • Dermacentor spp.
  • Amblyomma spp.


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ated with exposure to lagomorphs (rabbits, hares) and cats; type B infections are associated with rodents and cats, but not lagomorphs. Infections caused by biting arthropods (e.g., hard ticks [<span>Ixodes, Dermacentor, Amblyomma spp.], deerflies) are more common with type A than with type B strains. <span>

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Question
Comment expliquer l'augmentation de l'incidence de la Tularémie quand un hiver doux est suivi d'un été humide ?
Answer

Prolifération des tiques

"The incidence of disease increases dramatically when a relatively warm winter is followed by a wet summer, causing the tick population to proliferate." - Medical Microbiology


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The incidence of disease increases dramatically when a relatively warm winter is followed by a wet summer, causing the tick population to proliferate.

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Question
Astuce de chasseur pour reconnaître un lagomorphe potentiellement infecté par F. tularensis en zone d'endémie ?
Answer

S'il bouge tellement lentement qu'on peut le tirer sans mal, il est probablement infecté

"In areas where the organism is endemic, it is said that if a rabbit is moving so slowly that it can be shot by a hunter or caught by a pet, the rabbit could be infected" - Medical Microbiology


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In areas where the organism is endemic, it is said that if a rabbit is moving so slowly that it can be shot by a hunter or caught by a pet, the rabbit could be infected (Clinical Case 29-5).

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Question

A 63-year-old man initially presented with pain and localized swelling of his thumb 5 days after a cat bite.

Oral penicillins were prescribed, but the patient’s condition worsened, with increased local pain, swelling and erythema at the wound site, and systemic signs (fever, malaise, vomiting). Incision of the wound was performed, but no abscess was found; culture of the wound was positive for a light growth of coagulase-negative staphylococci. Intravenous penicillins were prescribed, but the patient continued to deteriorate, with the development of tender axillary lymphadenopathy and pulmonary symptoms.

A chest radiograph revealed pneumonic infiltrates in the right middle and lower lobes of the lung. The patient’s therapy was changed to clindamycin and gentamicin, which was followed by defervescence and improvement of his clinical status.

After 3 days of incubation, tiny colonies of faintly staining gram-negative coccobacilli were observed on the original wound culture. The organism was referred to a national reference laboratory, where it was identified as Francisella tularensis. A more complete history revealed the patient’s cat lived outdoors and fed on wild rodents.

Diagnosis ?

Answer

Tularémie après morsure de chat

"Capellan and Fong (Clin Infect Dis 16:472–475, 1993) described a 63-year-old man who developed ulceroglandular tularemia complicated by pneumonia after a cat bite" - Medical Microbiology


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Clinical Case 29-5 Cat-Associated Tularemia Capellan and Fong (Clin Infect Dis 16:472–475, 1993) described a 63-year- old man who developed ulceroglandular tularemia complicated by pneumo- nia after a cat bite. He initially presented with pain and localized swelling of his thumb 5 days after the bite. Oral penicillins were prescribed, but the patient’s condition worsened, with increased local pain, swelling and ery- thema at the wound site, and systemic signs (fever, malaise, vomiting). Incision of the wound was performed, but no abscess was found; culture of the wound was positive for a light growth of coagulase-negative staphy- lococci. Intravenous penicillins were prescribed, but the patient continued to deteriorate, with the development of tender axillary lymphadenopathy and pulmonary symptoms. A chest radiograph revealed pneumonic infiltrates in the right middle and lower lobes of the lung. The patient’s therapy was changed to clindamycin and gentamicin, which was followed by deferves- cence and improvement of his clinical status. After 3 days of incubation, tiny colonies of faintly staining gram-negative coccobacilli were observed on the original wound culture. The organism was referred to a national refer- ence laboratory, where it was identified as Francisella tularensis. A more complete history revealed the patient’s cat lived outdoors and fed on wild rodents. This case illustrates the difficulty in making the diagnosis of tula- remia and the lack of responsiveness to penicillins

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Question
Quelle est la forme clinique la plus fréquente de tularémie ?
Answer

Ulcéro-glandulaire

"Ulceroglandular tularemia is the most common manifestation" - Medical Microbiology


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Ulceroglandular tularemia is the most common manifes- tation. The skin lesion, which starts as a painful papule, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident). The papule t

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Question
Quelle est le premier type de lésion élémentaire à apparaître au site d'inoculation de la tularémie dans la forme ulcéro-glandulaire ?
Answer

Papule

"The skin lesion, which starts as a painful papule, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident)" - Medical Microbiology


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Ulceroglandular tularemia is the most common manifes- tation. The skin lesion, which starts as a painful papule, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident). The papule then ulcerates and has a necrotic center and raised border. Localized lymphadenopathy and bacteremia are also typically present (although bacteremia may be difficult to docu

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Question
Vers quel aspect évolue la première lésion élémentaire initialement présente au site d'inoculation de la tularémie dans la forme ulcéro-glandulaire ?
Answer

Aspect d'ulcération nécrotique

"The papule then ulcerates and has a necrotic center and raised border." - Medical Microbiology


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mmon manifes- tation. The skin lesion, which starts as a painful papule, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident). <span>The papule then ulcerates and has a necrotic center and raised border. Localized lymphadenopathy and bacteremia are also typically present (although bacteremia may be difficult to document) <span>

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Question
Quelle est la caractéristique des bords de la lésion ulcérée faisant suite à la papule présente au site d'inoculation de la tularémie dans la forme ulcéro-glandulaire ?
Answer

Bords surélevés

"[...] ulcerates and has a necrotic center and raised border" - Medical Microbiology


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tion. The skin lesion, which starts as a painful papule, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident). The papule then <span>ulcerates and has a necrotic center and raised border. Localized lymphadenopathy and bacteremia are also typically present (although bacteremia may be difficult to document) <span>

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Question
Que peut-on généralement palper en rapport avec la lésion d'inoculation de la tularémie dans la forme ulcéro-glandulaire ?
Answer

Adénopathie

"Localized lymphadenopathy and bacteremia are also typically present" - Medical Microbiology


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, develops at the site of the tick bite or direct inoculation of the organism into the skin (e.g., a laboratory accident). The papule then ulcerates and has a necrotic center and raised border. <span>Localized lymphadenopathy and bacteremia are also typically present (although bacteremia may be difficult to document) <span>

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Question
Dans les suites de quelle voie de contamination survient la tuléramie oculoglandulaire ?
Answer

Contamination oculaire directe

"Oculoglandular tularemia (Figure 29-5) is a specialized form of the disease and results from direct contamination of the eye." - Medical Microbiology


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Oculoglandular tularemia (Figure 29-5) is a specialized form of the disease and results from direct contamination of the eye. The organism can be introduced into the eyes, for example, by contaminated fingers or through exposure to water or aerosols. Affected patients have a painful conjunc- tivitis and region

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Question
Par quels signes cliniques se manifeste la tularémie dans sa forme oculo-glandulaire ?
[unknown IMAGE 7676711013644]
Answer

Conjonctivite douloureuse et adénopathie locale

"Affected patients have a painful conjunctivitis and regional lymphadenopathy" - Medical Microbiology


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orm of the disease and results from direct contamination of the eye. The organism can be introduced into the eyes, for example, by contaminated fingers or through exposure to water or aerosols. <span>Affected patients have a painful conjunc- tivitis and regional lymphadenopathy <span>

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Question
Pourquoi les examens directs de coloration de Gram des aspirations ganglionnaires ou de suc d'ulcères sont aussi souvent "négatives" au cours de la tularémie ?
Answer

Cocobacille de petite taille et faiblement coloré au Gram

"Detection of F. tularensis in Gram-stained aspirates from infected nodes or ulcers is almost always unsuccessful because the organism is extremely small and stains faintly" - Medical Microbiology


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Detection of F. tularensis in Gram-stained aspirates from infected nodes or ulcers is almost always unsuccessful because the organism is extremely small and stains faintly (see Figure 29-4).

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Question
Environ combien de temps incuber des hémocultures au cours d'une suspicion de Tularémie pour espérer les voir "positives" ?
Answer

Au moins une semaine

"Blood cultures are generally negative for the organism unless the cultures are incubated for a week or longer" - Medical Microbiology


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Blood cultures are generally negative for the organism unless the cultures are incubated for a week or longer.

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Question
Sur le milieu de culture de quelle autre bactérie intracellulaire responsable de pneumonies F. tularensis peut-elle pousser ?
Answer

Agar BCYE utilisé pour Legionella spp.

F. tularensis also grows on the selective media used for Legionella (e.g., BCYE agar)


BCYE = Buffered Charcoal Yeast Extract - Wikipedia : https://fr.wikipedia.org/wiki/Milieu_BCYE


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F. tularensis also grows on the selective media used for Legio- nella (e.g., BCYE agar). Aspirates of lymph nodes or draining sinuses are usually positive if the cultures are incubated for 3 days or longer.

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Question
En cas de suspicion de Tularémie, combien de temps incuber les cultures issues d'aspirations ganglionnaires pour espérer les voir "positives" ?
Answer

Au moins 3 jours

"Aspirates of lymph nodes or draining sinuses are usually positive if the cultures are incubated for 3 days or longer." - Medical Microbiology


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F. tularensis also grows on the selective media used for Legio- nella (e.g., BCYE agar). Aspirates of lymph nodes or draining sinuses are usually positive if the cultures are incubated for 3 days or longer.

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Question
À quel pathogène penser devant un petit cocobacille Gram négatif prenant faiblement la coloration ne poussant que sur gélose chocolat supplémentée et pas sur gélose au sang ?
Answer

Francisella tularensis

"Preliminary identification of F. tularensis is based on the slow growth of very small gram-negative coccobacilli on chocolate agar but not blood agar [...]" - Medical Microbioloy


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Preliminary identification of F. tularensis is based on the slow growth of very small gram-negative coccobacilli on chocolate agar but not blood agar (blood agar is not supple- mented with cysteine). The identification is confirmed by demonstrating the reactivity of the bacteria with specific antiserum (i.e., agglutination of the organism with antibod- ies against Francisella) </sp

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Question
Pourquoi F.tularensis ne pousse pas sur une gélose au sang alors qu'elle pousse sur une gélose chocolat supplémentée ?
Answer

Car gélose chocolat supplémentée l'est en Cystéine, essentielle pour la plupart des espèces de Francisella, et l'agar au sang n'est pas supplémentée en Cystéine.

Medical Microbiology


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Preliminary identification of F. tularensis is based on the slow growth of very small gram-negative coccobacilli on chocolate agar but not blood agar (blood agar is not supple- mented with cysteine). The identification is confirmed by demonstrating the reactivity of the bacteria with specific antiserum (i.e., agglutination of the organism with antibod- ies against Francisella) </spa

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Question
De quel facteur doivent être multiplié les titres d'anticorps de base pour permettre de poser un diagnostic de Tularémie si la sérologie de base est faiblement positive ?
Answer

Multipliés par 4

"Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness [...]" - Medical Microbiology


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Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness or a single titer of 1 : 160 or greater. However, antibodies (including immunoglobulin [Ig]G, IgM, and IgA) can persist for many years, making it difficult to differentiate between past and current disease

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[default - edit me]
Answer
Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness or a single titer of 1 : 160 or greater.

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Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness or a single titer of 1 : 160 or greater. However, antibodies (including immunoglobulin [Ig]G, IgM, and IgA) can persist for many years, making it difficult to differentiate between past and current disease

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Question
Sur quelle valeur de titre d'anticorps sur la première sérologie réalisée peut-on retenir le diagnostic de Tularémie ?
Answer

≥ 1 : 160ème

"Tularemia is diagnosed in most patients by the finding of a [...] or a single titer of 1 : 160 or greater." - Medical Microbiology


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Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness or a single titer of 1 : 160 or greater. However, antibodies (including immunoglobulin [Ig]G, IgM, and IgA) can persist for many years, making it difficult to differentiate between past and current disease

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Question
Sur quelle échelle de temps une sérologie Tularémie peut-elle rester positive après une infection ?
Answer

Sur des années

"However, antibodies (including immunoglobulin [Ig]G, IgM, and IgA) can persist for many years, making it difficult to differentiate between past and current disease" - Medical Microbiology


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Tularemia is diagnosed in most patients by the finding of a fourfold or greater increase in the titer of antibodies during the illness or a single titer of 1 : 160 or greater. However, antibodies (including immunoglobulin [Ig]G, IgM, and IgA) can persist for many years, making it difficult to differentiate between past and current disease

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Question
Quel mécanisme de résistance de F. tularensis explique l'inefficacité générale des Beta-Lactamines ?
Answer

Production d'une Beta-Lactamase

"F. tularensis strains produce β-lactamase, which renders penicillins and cephalosporins ineffective" - Medical Microbiology


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F. tularensis strains produce β-lactamase, which renders penicillins and cephalosporins ineffective.

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Question
Par quel moyen la tique permet la transmission de F. tularensis au patient ?
Answer

Contamination du site de morsure par les fécès de la tique

"Because the organism is present in the arthropod’s feces and not saliva, the tick must feed for a prolonged time before the infection is transmitted." - Medical Microbiology


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Because the organism is present in the arthropod’s feces and not saliva, the tick must feed for a prolonged time before the infection is transmitted. Prompt removal of the tick can therefore prevent infection

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Question
À quelle vitesse se fait la transmission de F. tularensis après morsure de tique (ordre d'idée qualitatif) ?
Answer

Lentement

"Because the organism is present in the arthropod’s feces and not saliva, the tick must feed for a prolonged time before the infection is transmitted. Prompt removal of the tick can therefore prevent infection" - Medical Microbiology


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Because the organism is present in the arthropod’s feces and not saliva, the tick must feed for a prolonged time before the infection is transmitted. Prompt removal of the tick can therefore prevent infection

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Question
Quelle maladie infectieuse est désignée par ces synonymes : "deer-fly fever, rabbit fever, market men disease, water-rat trappers disease, wild hare disease (yato-byo), and Ohara disease"
Answer

Tularémie (Francisella tularensis)


  • Deer-fly fever (fièvre du taon) :

    • Fait référence à la transmission par les taons (Chrysops), vecteurs de la maladie dans certaines régions, notamment en Amérique du Nord.
  • Rabbit fever (fièvre du lapin)

  • Market men disease (maladie des commerçants de marché)

  • Water-rat trappers disease (maladie des trappeurs de rats d’eau) :

    • Désigne l’infection des trappeurs manipulant des rongeurs aquatiques (rats musqués, castors), qui sont également des hôtes de Francisella tularensis.
  • Wild hare disease (Yato-byo) (maladie du lièvre sauvage, "Yato-byo" en japonais) :

    • Nom utilisé au Japon, où la maladie est souvent associée à la chasse et la consommation de lièvres sauvages.
  • Ohara disease :

    • Autre terme utilisé au Japon, en hommage au médecin japonais Ohara, qui a décrit la maladie dans ce pays au début du XXe siècle.

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Synonyms include Francis disease, deer-fly fever, rabbit fever, market men disease, water-rat trappers disease, wild hare disease (yato-byo), and Ohara disease [ 1]

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a zoonotic infection caused by Francisella tularensis, an aerobic and fastidious gram-negative bacterium. Human infection occurs following contact with infected animals or invertebrate vectors. <span>Synonyms include Francis disease, deer-fly fever, rabbit fever, market men disease, water-rat trappers disease, wild hare disease (yato-byo), and Ohara disease [1]. The clinical manifestations of Francisella infection may range from asymptomatic illness to septic shock and death, in part depending on the virulence of the infecting strain, portal o







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Question
Citer 4 facteurs ayant un impact sur la gravité de l'infection à F. tularensis ?
Answer
  • Virulence de la souche
  • Porte d'entrée
  • Inoculum
  • Statut immunitaire

"The clinical manifestations of Francisella infection may range from asymptomatic illness to septic shock and death, in part depending on the virulence of the infecting strain, portal of entry, inoculum, and the immune status of the host [1]." - UpToDate


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The clinical manifestations of Francisella infection may range from asymptomatic illness to septic shock and death, in part depending on the virulence of the infecting strain, portal of entry, inoculum, and the immune status of the host [1].

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als or invertebrate vectors. Synonyms include Francis disease, deer-fly fever, rabbit fever, market men disease, water-rat trappers disease, wild hare disease (yato-byo), and Ohara disease [1]. <span>The clinical manifestations of Francisella infection may range from asymptomatic illness to septic shock and death, in part depending on the virulence of the infecting strain, portal of entry, inoculum, and the immune status of the host [1]. The clinical manifestations, diagnosis, treatment, and prevention of tularemia will be reviewed here. The microbiology, pathogenesis, and epidemiology of infection due to F. tularensis







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Question
Quelle autre pathologie infectieuse peut être mimée par la forme oropharyngée de la tularémie et par quel détail à l'examen clinique ?
Answer
La diphtérie : membrane pharyngée
"In addition, a pharyngeal membrane mimicking diphtheria can occur [15]." - UpToDate

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n exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nodes also may be enlarged and tender. <span>In addition, a pharyngeal membrane mimicking diphtheria can occur [15]. <span>

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ission can also occur from oral exposure to contaminated droplets or by hand-to-mouth exposure (eg, in the setting of finger contamination from crushing ticks or handling contaminated animals). <span>The major symptoms are fever, severe sore throat, and swelling in the neck [14]. Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nodes also may be enlarged and tender. In addition, a pharyngeal membrane mimicking diphtheria can occur [15]. Pneumonic disease — Pneumonic tularemia refers to a clinical presentation dominated by pulmonary involvement. Pneumonic disease is more common in adults but can affect any age group and







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Question
Que peut-on observer sur le pharynx et les amygdales à l'examen clinique d'une Tularémie oropharyngée ?
Answer

Ulcères et exsudat pharyngés et amygdaliens

"Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers" - UpToDate


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The major symptoms are fever, severe sore throat, and swelling in the neck [14]. Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nodes also may be enlarged and tender. In addition, a pharyngeal membrane mimicking diphtheria can occur [15].

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ission can also occur from oral exposure to contaminated droplets or by hand-to-mouth exposure (eg, in the setting of finger contamination from crushing ticks or handling contaminated animals). <span>The major symptoms are fever, severe sore throat, and swelling in the neck [14]. Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nodes also may be enlarged and tender. In addition, a pharyngeal membrane mimicking diphtheria can occur [15]. Pneumonic disease — Pneumonic tularemia refers to a clinical presentation dominated by pulmonary involvement. Pneumonic disease is more common in adults but can affect any age group and







Flashcard 7679338482956

Tags
#Clinical #Cliniques #Diagnosis #Diagnostic #Maladies-infectieuses-et-tropicales #Manifestations #Tularemia #Tularemie
Question
Quels sont les trois principaux symptômes / signes à l'inspection globale de la Tularémie oropharyngée ?
Answer
  • Fièvre
  • Douleur pharyngée intense
  • Oedème cervical

"The major symptoms are fever, severe sore throat, and swelling in the neck [14]" - UpToDate


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The major symptoms are fever, severe sore throat, and swelling in the neck [14]. Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nod

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UpToDate
ission can also occur from oral exposure to contaminated droplets or by hand-to-mouth exposure (eg, in the setting of finger contamination from crushing ticks or handling contaminated animals). <span>The major symptoms are fever, severe sore throat, and swelling in the neck [14]. Examination demonstrates an exudative pharyngitis and tonsillitis, cervical lymph node enlargement, and usually pharyngeal or tonsillar ulcers. Preparotid and retropharyngeal lymph nodes also may be enlarged and tender. In addition, a pharyngeal membrane mimicking diphtheria can occur [15]. Pneumonic disease — Pneumonic tularemia refers to a clinical presentation dominated by pulmonary involvement. Pneumonic disease is more common in adults but can affect any age group and







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