{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:17:36Z","timestamp":1791584256390,"version":"4.3.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:00:00Z","timestamp":1600473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Mediterranee Infection Foundation"},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"publisher","award":["ANR-10-IAHU-03"],"award-info":[{"award-number":["ANR-10-IAHU-03"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We describe the epidemiological, clinical, and prognostic aspects of 177 tularemia cases diagnosed at the National Reference Center for rickettsioses, coxiellosis, and bartonelloses between 2008 and 2017.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All patients with a microbiological diagnosis of tularemia made in the laboratory were included. Clinical and epidemiological data were collected retrospectively from clinicians in charge of patients using a standardized questionnaire. Diagnostic methods used were indirect immunofluorescence serology, real-time polymerase chain reaction (PCR), and universal PCR targeting the 16S ribosomal ribonucleic acid gene.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The series included 54 females and 123 males (sex ratio, 2.28; mean age, 47.38 years). Eighty-nine (50.2%) were confirmed as having tularemia on the basis of a positive Francisella tularensis PCR or seroconversion, and 88 (49.8%) were considered as probable due to a single positive serum. The regions of France that were most affected included Pays de la Loire (22% of cases), Nouvelle Aquitaine (18.6% of cases), and Grand Est (12.4% of cases). Patients became infected mainly through contact with rodents or game (38 cases, 21.4%), through tick-bites (23 cases, 12.9%), or during outdoor leisure activities (37 cases, 20.9%). Glandular and ulceroglandular forms were the most frequent (109 cases, 61.5%). Two aortitis, an infectious endocarditis, a myocarditis, an osteoarticular infection, and a splenic hematoma were also diagnosed. Tularemia was discovered incidentally in 54.8% of cases. Seventy-eight patients were hospitalized, and no deaths were reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our data suggest that in an endemic area and\/or in certain epidemiological contexts, tularemia should be sought to allow an optimized antibiotic therapy and a faster recovery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa440","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T09:34:25Z","timestamp":1600508065000},"source":"Crossref","is-referenced-by-count":29,"title":["Tularemia: A Case Series of Patients Diagnosed at the National Reference Center for Rickettsioses From 2008 to 2017"],"prefix":"10.1093","volume":"7","author":[{"given":"Anne","family":"Darmon-Curti","sequence":"first","affiliation":[{"name":"Aix Marseille University, Institut de Recherche pour le Developpement (IRD), MEPHI, Institut Hospitalo Universitaire (IHU)-M\u00e9diterran\u00e9e Infection, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Darmon","sequence":"additional","affiliation":[{"name":"Laboratoire d'Informatique Gaspard-Monge (LIGM), Unit\u00e9 Mixte de Recherche (UMR) 8049, Ecole des Ponts ParisTech, UPE, Marne-la-Vall\u00e9e, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Edouard","sequence":"additional","affiliation":[{"name":"Aix Marseille University, Institut de Recherche pour le Developpement (IRD), MEPHI, Institut Hospitalo Universitaire (IHU)-M\u00e9diterran\u00e9e Infection, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Hennebique","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence des Francisella, Institut de Biologie et de Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France"},{"name":"Universit\u00e9 Grenoble Alpes, Centre National de la Recherche Scientifique, TIMC-IMAG, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Guimard","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Emergency Department, Centre Hospitalier de La Roche sur Yon, La Roche-sur-Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Martin-Blondel","sequence":"additional","affiliation":[{"name":"Service des Maladies Infectieuses et Tropicales, CHU de Toulouse, Toulouse, France"},{"name":"UMR INSERM\/CNRS 1043, Centre de Physiopathologie Toulouse Purpan, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timoth\u00e9e","family":"Klopfenstein","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Besancon University Hospital, Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Talarmin","sequence":"additional","affiliation":[{"name":"Internal Medicine and Infectious Diseases Department, Centre Hospitalier de Cornouaille, Quimper, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"Aix Marseille University, Institut de Recherche pour le Developpement (IRD), MEPHI, Institut Hospitalo Universitaire (IHU)-M\u00e9diterran\u00e9e Infection, Marseille, France"},{"name":"Centre National de R\u00e9f\u00e9rence des Rickettsia, Coxiella et Bartonella, IHU-M\u00e9diterran\u00e9e Infection, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Maurin","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence des Francisella, Institut de Biologie et de Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France"},{"name":"Universit\u00e9 Grenoble Alpes, Centre National de la Recherche Scientifique, TIMC-IMAG, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Edouard","family":"Fournier","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence des Rickettsia, Coxiella et Bartonella, IHU-M\u00e9diterran\u00e9e Infection, Marseille, France"},{"name":"Aix Marseille University, IRD, Service de Sant\u00e9 des Arm\u00e9es, VITROME, IHU-M\u00e9diterran\u00e9e Infection, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,19]]},"reference":[{"key":"2020110908090185400_CIT0001","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/infdis\/10.1.61","article-title":"Further observations on a plague-like disease of rodents with a preliminary note on the causative agent, bacterium tularense","volume":"10","author":"McCoy 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