Signs and Symptoms of Tularemia

Signs and symptoms

• Ulceroglandular This is the most common form of tularemia and usually occurs following a tick or deer fly bite or after handing of an infected animal. A skin ulcer appears at the site where the bacteria entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
• Glandular Similar to ulceroglandular tularemia but without an ulcer. Also generally acquired through the bite of an infected tick or deer fly or from handling sick or dead animals.
• Oculoglandular This form occurs when the bacteria enter through the eye. This can occur when a person is butchering an infected animal and touches his or her eyes. Symptoms include irritation and inflammation of the eye and swelling of lymph glands in front of the ear.
• Oropharyngeal This form results from eating or drinking contaminated food or water. Patients with orophyangeal tularemia may have sore throat, mouth ulcers, tonsillitis, and swelling of lymph glands in the neck.
• Pneumonic This is the most serious form of tularemia. Symptoms include cough, chest pain, and difficulty breathing. This form results from breathing dusts or aerosols containing the organism. It can also occur when other forms of tularemia (e.g. ulceroglandular) are left untreated and the bacteria spread through the bloodstream to the lungs.
• Typhoidal This form is characterized by any combination of the general symptoms (without the localizing symptoms of other syndromes)

When to talk to your doctor

Tularemia can be difficult to diagnose. It is a rare disease, and the symptoms can be mistaken for other, more common illnesses. For this reason, it is important to share with your health care provider any likely exposures, such as tick and deer fly bites, or contact with sick or dead animals.