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Symptoms
By Mayo Clinic staffMost people exposed to tularemia who become sick generally do so within two to 10 days. Several types of tularemia exist, and which type you get depends on how and where the bacteria enter the body. Most commonly, they enter through skin or mucous membranes, but they can also be inhaled or eaten. Each type of tularemia has 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)
- Mouth ulcers
- 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 and have developed fever, skin ulcers or swollen glands — see a doctor as soon as possible. If you test positive for the disease, you'll need to start antibiotic treatment right away.
- Tularemia. Centers for Disease Control and Prevention. http://www.cdc.gov/tularemia/index.html. Accessed May 4, 2012.
- Longo DL, et al. Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9122226. Accessed May 4, 2012.
- McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed May 4, 2012.
- Graham J, et al. Tick-borne illnesses: A CME update. Pediatric Emergency Care. 2011;27:141.
- Snowden J, et al. Tularemia: Retrospective review of 10 years' experience in Arkansas. Clinical Pediatrics. 2011;50:64.
- Conlan JW. Tularemia vaccines: Recent developments and remaining hurdles. Future Microbiology. 2011;6:391.
- Safe minimum cooking temperatures. FoodSafety.gov. http://www.foodsafety.gov/keep/charts/mintemp.html. Accessed May 15, 2012.
- Game from farm to table. USDA Food Safety and Inspection Service. http://www.fsis.usda.gov/fact_sheets/farm_raised_game/index.asp. Accessed May 15, 2012.
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