Most 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.

Aug. 30, 2012

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