Histologic and molecular diagnosis of tularemia: a potential bioterrorism agent endemic to North America

被引:61
作者
Lamps, LW
Havens, JM
Sjostedt, A
Page, DL
Scott, MA
机构
[1] Univ Arkansas Med Sci, Dept Pathol, Little Rock, AR 72205 USA
[2] Umea Univ, Dept Clin Microbiol, Umea, Sweden
[3] Vanderbilt Univ, Sch Med, Dept Pathol, Nashville, TN 37212 USA
[4] Cent Arkansas Vet Healthcare Syst, Dept Pathol, Little Rock, AR USA
关键词
Francisella tularensis; tularemia; polymerase chain reaction; tick-borne; bioterrorism; molecular diagnosis; immunohistochemistry;
D O I
10.1038/modpathol.3800087
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Francisella tularensis (FT), a zoonotic bacterium that causes tularemia, has received attention as a possible bioterrorism threat. We developed a PCR assay for use in fixed, processed tissues, which are safer to handle and allow archival testing. PCR analysis for a 211-bp fragment of the FT lipoprotein gene was performed on tissues from 16 cases of tularemia. In all, 14/15 cases with intact DNA (93%) were positive for FT by PCR. Frequent histologic findings in PCR-positive tissues included irregular microabscesses and granulomas in liver, spleen, kidney, and lymph nodes, and necrotizing pneumonia. Unusual cases featuring suppurative leptomeningitis and gastrointestinal ulcers were also seen. As this disease is endemic in North America, and has been identified as a potential bioterroristic threat, awareness of the clinicopathologic spectrum of disease and available detection methods is increasingly important. This PCR assay, the first designed for use in processed tissues, is an excellent method for diagnosis of tularemia.
引用
收藏
页码:489 / 495
页数:7
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