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Volume 26, Number 10—October 2020
Dispatch

Seawater-Associated Highly Pathogenic Francisella hispaniensis Infections Causing Multiple Organ Failure

Hua Zhou1, Qing Yang1, Lisha Shen, Yake Yao, Jun Xu, Junhui Ye, Xiaomai Wu, Yunsong Yu, Ziqin Li, Jianying ZhouComments to Author , and Shangxin YangComments to Author 
Author affiliations: The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (H. Zhou, L. Shen, Y. Yao, J. Xu, J. Zhou); State Key Laboratory for Diagnostic and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou (Q. Yang); Sanmen People’s Hosptial, Taizhou, China (J. Ye); Taizhou Hospital, Taizhou (X. Wu); Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou (Y. Yu); Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou (Z. Li, S. Yang); UCLA School of Medicine, Los Angeles, California, USA (S. Yang)

Main Article

Table 1

Blood test results during progression of Francisella hispaniensis infection and after treatment of a 64-year-old fisherman with multiple organ failure, China

Blood test (reference range) Outside hospital, 4 d after fever onset At admission, 16 d after fever onset After treatment, 14 d after admission
Leukocytes, cells/mm3 (4,000–10,000)
16,600
22,800
10,700
Differential count, %
Neutrophils (50–70) 90.6 81.1 84.2
Lymphocytes (20–40)
5.1
16
8.7
Platelets/mm3 (83,000–303,000)
174,000
145,000
159,000
Hemoglobin, g/dL (13.1–17.2) 13.4 10.7 6.8
Creatinine, mg/dL (0.7–1.2) 0.6 2.6 1.5
Albumin, g/dL (3.5–5.5)
2.97
2.81
2.72
Alanine aminotransferase, U/L (5–40) 47 394 27
Aspartate aminotransferase, U/L (8–40) 53 1911 22
Total bilirubin, mg/dL (0–1.3) 0.9 6.3 1.2
Direct bilirubin, mg/dL (0–0.3)
0.4
4.8
0.8
Activated partial thromboplastin time, s (14.5–21.5) 40.1 82.5 36.5
Prothrombin time, s (10.0–13.5) 15.1 40.8 12.8
Fibrinogen, g/L (2.0–4.0) 8.83 1.28 3.2
Troponin I, ng/mL (0–0.06) Not available 1.13 0.1
N-terminal pro-brain natriuretic peptide, pg/mL (0–80)
Not available
>9,000
1,845
Arterial blood pH (7.35–7.45) 7.45 7.21 7.48
Arterial partial pressure of oxygen, mm Hg (80–100) 50 130 138
Arterial partial pressure of carbon dioxide, mm Hg (35–45)
32
36
32
Lactate, mmol/L (0.5–2.2) Not available 14.2 1.6
C-reactive protein, mg/L (0–8) Not available 292.6 96.8
Procalcitonin, ng/mL (0–0.5) Not available 12.84 0.30

Main Article

1These authors contributed equally to this article.

Page created: July 13, 2020
Page updated: September 17, 2020
Page reviewed: September 17, 2020
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