Tularemia (Francisella Tularensis)

Your Path

  • Tularemia (Francisella tularensis)


  • Skin
  • Lymph nodes
  • Oropharynx
  • Lungs


  • Gram negative rod
  • Passed from dying wild animals (e.g. rabbits, muskrats, rabbits, rodents) or sometimes domestic cats to humans via ticks or deer flies
  • Can also spread via bio-terrorism

Risk Factors

  • US Southeast and Rocky Mtns
  • Infected animal exposure


  • F, c, ha, muscle aches
  • Ulceroglandular form: skin ulcers at site of innoculation; then regional adenopathy (arm pit, inguinal region in particular)
  • Glandular form: proressive, painful adenopathy (but no skin ulcers)
  • Pneumonic form: cough, sob, cp; most severe form; can result from inhaled particles or spread from other sites
  • Oropharyngeal (ingesting contaminated water): oral ulcers, sore throat, adenopathy

Physical Exam Findings

  • Skin ulcers (ulderoglandular)
  • Painful, sub-acutely progressive, inflammatory adenopthy (ulceroglandular, glandular)
  • Lung findings (pneumonic)
  • Oral ulcers, adenopathy (oropharyngeal)