There are no guidelines for tularemic meningitis, which is a rare but serious condition.
The historical treatment is based on old and toxic molecules. Quinolones could be a more up-to-date alternative.
Francisella tularensis meningitis should be suspected based on clear cerebrospinal fluid, mostly with lymphocytes.
We report a French case of tularemic meningitis – the second to be thoroughly described – and discuss the existing literature.
The patient is a 64-year-old man with no medical history, who developed fever, cutaneous symptoms, and swollen lymph nodes within a week after a hunt. He was then diagnosed with meningitis caused by Francisella tularensis subsp. holarctica.
Healing was quickly achieved ad integrum within 3 weeks with a course of ciprofloxacin.
We discuss the existing literature about this specific issue, and try to shine a light on the superior efficacy and lesser toxicity of quinolones compared to the historical treatment.Le texte complet de cet article est disponible en PDF.
Keywords : Meningitis, Treatment, Tularemia