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Infection caused by Francisella

Last edited: 4/16/2026

Overview

Francisella hispaniensis infections are rare and can lead to severe clinical presentations, including skin and soft tissue infections progressing to bacteremia and multiple organ failure, particularly in individuals exposed to seawater environments 1.

Diagnosis

  • Clinical Presentation: Skin and soft tissue infection, bacteremia, and signs of multiple organ failure 1.
  • Laboratory Tests: Blood cultures for Francisella species identification 1.
  • Imaging: May reveal organ involvement consistent with multiple organ failure 1.
  • Diagnostic Criteria: Definitive diagnosis often requires isolation and identification of Francisella species from clinical samples 1.
  • Management

  • First-Line Treatment: Moxifloxacin has shown efficacy in clearing infections 1.
  • Adjunctive Measures: Supportive care including management of organ failure and monitoring for sequelae like heart damage 1.
  • Special Populations

  • Exposure Risk: Deep-sea divers and individuals with significant seawater exposure may be at higher risk 1.
  • Sequela Considerations: Particular attention to long-term cardiac health following severe infections 1.
  • Key Recommendations

  • Initiate empirical treatment with moxifloxacin for suspected Francisella hispaniensis infections until culture results are available (Evidence: Weak 1).
  • Provide comprehensive supportive care addressing multiple organ dysfunction in severe cases (Evidence: Weak 1).
  • Monitor and manage potential long-term sequelae, especially cardiac damage, in survivors of severe Francisella infections (Evidence: Expert opinion 1).
  • References

    1 Zhou H, Yang Q, Shen L, Yao Y, Xu J, Ye J et al.. Seawater-Associated Highly Pathogenic Francisella hispaniensis Infections Causing Multiple Organ Failure. Emerging infectious diseases 2020. link

    Original source

    1. [1]
      Seawater-Associated Highly Pathogenic Francisella hispaniensis Infections Causing Multiple Organ Failure.Zhou H, Yang Q, Shen L, Yao Y, Xu J, Ye J et al. Emerging infectious diseases (2020)

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