Most cases of cases of tularemia are not life-threatening, although some infections may be prolonged and debilitating. The pattern of these infections are usually determined by where the organism was introduced.
Systemic features:
(1) flu-like symptoms with chills and fever
(2) headache
(3) generalized aches
(4) transient bacteremia
Portal of Infection
Clinical Features
Clinical Type
fingers or hands from handling infected animals
skin ulceration at site of inoculation with regional lymphadenopathy
ulceroglandular
arms or legs bitten by insect
skin ulceration at insect bite with regional lymphadenopathy
ulceroglandular
skin (as above)
regional lymphadenopathy without skin ulceration
glandular
conjunctiva rubbed by contaminated fingers
conjunctival ulcers and nodules, cervical lymphadenopathy
oculoglandular
eaten contaminated meat or drinking contaminated water
eaten contaminated meat or drinking contaminated water
diarrhea, mucosal ulcerations
gastrointestinal
inhalation
pneumonia
pneumonic
where:
• There may be a period of time between the appearance of a localized ulcer and the regional lymphadenopathy.
• The pneumonic form can occur without overt signs of pneumonia and variable X-ray findings, making diagnosis difficult. It can also occur during the bacteremic stage of the other forms.
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