Francisella
Francisella is a genus of Gram-negative bacteria, which are facultative intracellular pathogens. The most well-known species within this genus is Francisella tularensis, the causative agent of tularemia or rabbit fever. This genus is named after Edward Francis, who studied tularemia extensively. Francisella species are small, non-motile bacteria that require cysteine for growth. They are widely distributed in the environment and can infect a range of hosts, including humans, domestic animals, and wildlife.
Characteristics
Francisella bacteria are characterized by their small size, pleomorphic shape, and the requirement for complex media enriched with cysteine or cystine for in vitro growth. They are aerobic and exhibit a unique lipid-rich outer membrane, which contributes to their virulence and ability to evade the host's immune response. The bacteria are known for their ability to survive and replicate within the cytosol of host cells, particularly macrophages, which is a key factor in their pathogenicity.
Pathogenesis
The pathogenesis of Francisella infections involves the bacteria's entry into the host, typically through skin abrasions, inhalation, or ingestion. Once inside the host, Francisella species evade the immune system by entering and replicating within macrophages. Their ability to inhibit phagosome-lysosome fusion and to escape into the cytosol is crucial for their survival and replication within host cells. The immune response to Francisella infection involves both innate and adaptive immunity, with the activation of inflammatory cytokines and the recruitment of immune cells to the site of infection.
Diseases
The most significant disease caused by Francisella species is tularemia, a zoonotic infection transmitted to humans through direct contact with infected animals, bites from arthropods such as ticks and flies, ingestion of contaminated water, or inhalation of aerosolized bacteria. Tularemia is characterized by fever, skin ulcers, lymphadenopathy, and pneumonia, depending on the route of infection. It is a potentially serious illness that requires prompt treatment with antibiotics.
Diagnosis and Treatment
Diagnosis of tularemia is based on clinical symptoms, history of exposure, and confirmed by laboratory tests, including culture, serology, and molecular methods such as PCR. Treatment typically involves the administration of antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin. Early diagnosis and treatment are crucial to prevent severe disease and complications.
Prevention
Preventive measures against Francisella infections include avoiding contact with wild animals, using insect repellent to prevent bites from ticks and flies, and ensuring water safety. In some high-risk areas, vaccination may be recommended for people who are at increased risk of exposure to Francisella tularensis.
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Contributors: Prab R. Tumpati, MD