Mastering Tularemia | A Comprehensive Guide to Five Distinct Tularemia Types

Below, we discuss five types of Tularemia. First Ulceroglandular tularemia, then Oculoglandular tularemia, followed by Pulmonary tularemia, Gastrointestinal tularemia, and lastly Generalized tularemia.

1. Ulceroglandular tularemia

Ulceroglandular Tularemia, the most common form of Tularemia, also known as deerfly fever, is a rare bacterial infection caused by Francisella tularensis, spread from infected rodents and other wild animals through infected tick or flying insect bites by direct entry of the bacteria through cuts or sores after handling infected dead animals, or from the bacteria entering the bloodstream from other infected sites.

1.1 Symptoms

A patient with ulceroglandular Tularemia can experience;

• fever and chills;
• a skin ulcer (open sore) at the site of infection;
• muscle and joint pains,
• sweats; and
• enlarged lymph nodes, usually in the armpit or groin.

1.2 Diagnosis

The provider diagnoses the patient based on the patient’s history, symptoms, physical examination, and signs.

Laboratory tests include blood culture, serologic tests, polymerase chain reaction (PCR) for antibody identification, and microscopic analysis of specimens taken from lymph nodes or lesion biopsies.

1.3 Treatment

Treatment includes antibiotics such as doxycycline, ciprofloxacin, streptomycin, and tetracycline. Providers may educate patients on disease prevention, such as washing hands before eating, consuming fresh and clean food, drinking boiled or purified water, and wearing gloves while handling dead animals.

2. Oculoglandular tularemia

Oculoglandular Tularemia, also known as Ophthalmic Tularemia, refers to a rare bacterial infection of the eye caused by Francisella tularensis, which enters directly through the eye when the patient touches the eye after handling infected meat.

2.1 Symptoms

A patient with oculoglandular Tularemia can experience;

• fever;
• eye irritation and inflammation;
• discharge from the eye;
• possible lesions behind the eyelid; and
• enlarged lymph nodes around the ear.

2.2 Diagnosis

The provider diagnoses the patient based on the patient’s history, symptoms, physical examination, and signs.

Laboratory tests include blood culture, serologic tests, polymerase chain reaction (PCR) for antibody identification, and microscopic analysis of specimens taken from lymph nodes or lesion biopsies.

2.3 Treatment

Treatment includes antibiotics such as doxycycline, ciprofloxacin, streptomycin, and tetracycline.

Providers may educate patients on disease prevention, such as washing hands before eating, consuming fresh and clean food, drinking boiled or purified water, and wearing gloves while handling dead animals.

3. Pulmonary tularemia

Pulmonary Tularemia, the most severe form of Tularemia, is a bacterial infection that enters the lungs by inhaling dust from dirt contaminated by Francisella tularensis or when the bacteria enters the bloodstream due to untreated Tularemia at other sites.

3.1 Symptoms

Patients with pulmonary Tularemia can experience;

• fever;
• cough;
• chest pain;
• breathing problems;
• sweats; and
• enlarged lymph nodes, usually in the armpits.

3.2 Diagnosis

The provider diagnoses the patient based on the patient’s history, symptoms, physical examination, and signs.

Laboratory tests include blood culture, serologic tests, polymerase chain reaction (PCR) for antibody identification, and microscopic analysis of specimens taken from lymph nodes or lesion biopsies.

3.3 Treatment

Treatment includes antibiotics such as doxycycline, ciprofloxacin, streptomycin, and tetracycline. Providers may educate patients on disease prevention, such as washing hands before eating, consuming fresh and clean food, drinking boiled or purified water, and wearing gloves while handling dead animals.

4. Gastrointestinal tularemia

Gastrointestinal tularemia (GI), also known as Abdominal Tularemia, is a bacterial infection of the GI tract caused by Francisella tularensis, spread from infected rodents and other wild and domestic animals through infected tick or flying insect bites by direct entry of the bacteria through cuts or sores or touching the mouth with unwashed hands after handling infected dead animals, or from the bacteria entering the bloodstream from other infected sites.

4.1 Symptoms

A patient with gastrointestinal Tularemia can experience;

• fever;
• stomach pain;
• nausea;
• vomiting;
• sweating; and
• enlarged lymph nodes in the abdominal and inguinal areas.

4.2 Diagnosis

The provider diagnoses the patient based on history, symptoms, physical examination, and signs. Laboratory tests include blood culture, serologic tests, polymerase chain reaction (PCR) for antibody identification, and microscopic analysis of specimens taken from lymph nodes or lesion biopsies.

4.3 Treatment

Treatment includes antibiotics such as doxycycline, ciprofloxacin, streptomycin, and tetracycline.

Providers may educate patients on disease prevention, such as washing hands before eating, consuming fresh and clean food, drinking boiled or purified water, and wearing gloves while handling dead animals.

5. Generalized Tularemia

Generalized Tularemia is a rare bacterial infection that affects multiple organs or areas of the body at the same time. Tularemia is caused by Francisella tularensis, transmitted from infected rodents and other wild and domestic animals through infected ticks or flying insect bites by direct entry of the bacteria through cuts or sores or touching the mouth with unwashed hands after handling infected dead animals or from the bacteria entering the bloodstream from other infected sites.

5.1 Symptoms

Specific symptoms of Tularemia depend on the areas of the body affected. In general, however, a patient with generalized Tularemia can experience;

• the sudden onset of fever and chills;
• headache;
• backache;
• muscle and joint pains;
• sweats;
• red lesions that turn into open sores;
• difficulty breathing;
• extreme exhaustion;
• sore throat;
• loss of appetite;
• vomiting; and
• weight loss.

5.2 Diagnosis

The provider diagnoses the patient based on the patient’s history, symptoms, physical examination, and signs.

Laboratory tests include blood culture, serologic tests, polymerase chain reaction (PCR) for antibody identification, and microscopic analysis of specimens taken from lymph nodes or lesion biopsies. A chest X–ray may be performed to assess pulmonary involvement.

5.3 Treatment

Treatment includes antibiotics such as doxycycline, ciprofloxacin, streptomycin, and tetracycline.