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Volume 16, Number 1—January 2010


Real-Time PCR for Diagnosis of Oculoglandular Tularemia

Max MaurinComments to Author , Bernard Castan, Nathalie Roch, Brieuc Gestin, Isabelle Pelloux, Alexandra Mailles, Christophe Chiquet, and Pascal Chavanet
Author affiliations: Grenoble University Hospital, Grenoble, France (M. Maurin, B. Gestin, I. Pelloux, C. Chiquet); Joseph Fourier University, Grenoble (M. Maurin, B. Gestin, C. Chiquet); Auch Hospital, Auch, France (B. Castan); Dijon University Hospital, Dijon, France. (N. Roch, P. Chavanet); French Institute for Public Health Surveillance, Saint Maurice, France (A. Mailles)

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Characteristics of the 2 patients in the study and test results for tularemia, France*

Characteristic Patient A Patient B
Age, y/sex 43/F 42/F
Blood leukocyte count at admission, cells/mm3 21,600 4,000–10,000
Blood granulocyte count at admission, cells/mm3 17,900 2,000–8,000
C-reactive protein level at admission, mg/L
Serologic test results for Francisella tularensis
First serum sample, d 6 16
Microagglutination titer <20 <20
Immunofluorescent IgM titer <20 <20
Immunofluorescent IgG titer <20 <20
Second serum sample, d 90 39
Microagglutination titer 80 160
Immunofluorescent IgM titer 160 320
Immunofluorescent IgG titer
Real-time PCR result for ISFtu2 and tul4, sample (cycle threshold for each test, respectively) Positive, conjunctival discharge (32.4 and 34.9) Positive, pretragal lymph node (22.3 and 24.5)
Francisella sp. culture, sample Positive, conjunctival discharge Negative
Francisella subsp. identification subsp. holarctica subsp. holarctica

*Ig, immunoglobulin.

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