Periprosthetic hip infection by Francisella tularensis.
Cristina Gay González, Irati Arregui García, Jimmy Alonso Madrigal Cruz et al.
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Case in brief
A 63-year-old man presented with a prosthetic hip joint infection attributed to Francisella tularensis subspecies holarctica after rural exposure. Diagnosis was achieved through leukocyte-labelled scintigraphy, synovial fluid culture, and serological testing. The infection resolved following treatment with doxycycline and a one-stage prosthesis exchange.
What made this case unusual
This case highlights Francisella tularensis as an exceptionally rare cause of periprosthetic joint infection, which is often overlooked due to low clinical suspicion.
Diagnostic / clinical pearl
Clinicians should consider Francisella tularensis in the differential diagnosis of periprosthetic joint infections, especially in patients with relevant exposure history.
Why it matters
Awareness of this rare pathogen can improve diagnostic accuracy and patient outcomes in similar cases of periprosthetic infections.