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Symptoms
By Mayo Clinic staffMost people exposed to tularemia who become sick generally do so within two to 10 days, but incubation can take as little as few hours or as long as three weeks. Several types of tularemia exist, each with its own set of symptoms.
Ulceroglandular tularemia
This is by far the most common form of the disease. Signs and symptoms include:
- A skin ulcer that forms at the site of infection — usually an insect or animal bite
- Swollen and painful lymph glands
- Fever
- Chills
- Headache
- Exhaustion
Glandular tularemia
People with glandular tularemia have the same signs and symptoms of ulceroglandular tularemia, except no skin ulcers.
Oculoglandular tularemia
This form affects the eyes and may cause:
- Eye pain
- Eye redness
- Eye swelling and discharge
- An ulcer on the inside of the eyelid
Oropharyngeal tularemia
Usually caused by eating poorly cooked wild animal meat or drinking contaminated water, this form affects the digestive tract. Signs and symptoms include:
- Fever
- Sore throat (pharyngitis)
- Vomiting
- Diarrhea
Pneumonic tularemia
More common in the elderly and in people with typhoidal tularemia, this causes signs and symptoms typical of pneumonia:
- Cough
- Chest pain
- Difficulty breathing
Other forms of tularemia also can spread to the lungs.
Typhoidal tularemia
This rare and serious form of the disease usually causes:
- High fever
- Extreme exhaustion
- Vomiting and diarrhea
- Enlarged spleen (splenomegaly)
- Enlarged liver (hepatomegaly)
- Pneumonia
When to see a doctor
If you think you may have been exposed to tularemia — especially if you've been bitten by a tick or handled a wild animal in an area where tularemia is found — see a doctor as soon as possible. If you test positive for the disease, you'll need to start antibiotic treatment right away.
- Frequently asked questions (FAQ) about tularemia. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/agent/tularemia/faq.asp. Accessed Feb. 15, 2010.
- Nigrovic LE, et al. Tularemia. Infectious Disease Clinics of North America. 2008;22:489.
- Everett. ED. Clinical manifestations, diagnosis, and treatment of tularemia. http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2010.
- Everett ED. Microbiology, pathogenesis, and epidemiology of tularemia, http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2010.
- Eisen RJ, et al. Ecoepidemiology of tularemia in the Southcentral United States. American Journal of Tropical Medicine & Hygiene. 2008;78:586.
- Tularemia: Surveillance reported cases by state. Centers for Disease Control and Prevention. http://www.cdc.gov/tularemia/Surveillance/Tul_CasesbyState.html. Accessed March 2, 2010.
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