Because it's rare and because it shares symptoms with other diseases, tularemia may be difficult to diagnose. If you've participated in any activities that increase your risk, such as hunting rabbit, let your doctor know.

Tularemia can usually be diagnosed through blood tests. One test looks for antibodies to the bacteria, and that test won't show that you've had the infection until several weeks later. You may also have a chest X-ray to look for signs of pneumonia.

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Tularemia can be effectively treated with antibiotics given by injection directly into a muscle or vein. The antibiotic gentamicin is typically the treatment of choice for tularemia. Streptomycin is also effective, but can be hard to get and may have more side effects than other antibiotics.

Depending on the type of tularemia being treated, doctors may prescribe oral antibiotics such as doxycycline (Oracea, Vibramycin, others) or ciprofloxacin (Cipro) instead.

You'll also receive therapy for any complications such as meningitis or pneumonia. In general, you should be immune to tularemia after recovering from the disease, but some people may experience a recurrence or reinfection.

Preparing for your appointment

You're likely to start by seeing your primary care doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to an infectious diseases specialist.

Here's information to help you prepare for your appointment.

What you can do

  • List your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, especially recent activities, such as hunting or gardening or traveling to tick-infested areas.
  • Take a list of all medications, vitamins or supplements you're taking.
  • Write down questions to ask your doctor.

Preparing a list of questions for your doctor will help you make the most of your time together. For tularemia, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there other possible causes?
  • What tests do I need?
  • What treatments are available? And what side effects can I expect?
  • I have other health conditions. How can I best manage these conditions together?
  • Are there brochures or other printed material I can take with me? What websites do you recommend?

Don't hesitate to ask any other questions you may have.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • When did you begin experiencing symptoms?
  • Have you been hunting, gardening or traveling to tick-heavy areas recently?
  • Have your symptoms been continuous, or do they come and go?
  • How severe are your symptoms?
  • Does anything improve your symptoms?
  • Is there anything that makes your symptoms worse?
Nov. 06, 2020
  1. AskMayoExpert. Tularemia. Mayo Clinic; 2020.
  2. Tularemia statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/tularemia/statistics/index.html. Accessed Oct. 12, 2020.
  3. Ferri FF. Tularemia. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Oct. 12, 2020.
  4. Goldman L, et al., eds. Tularemia and other Francisella infections. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Oct. 12, 2020.
  5. Penn RL. Clinical manifestations, diagnosis, and treatment of tularemia. https://www.uptodate.com/contents/search. Accessed Oct. 12, 2020.
  6. Tularemia prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/tularemia/prevention/index.html. Accessed Oct. 12, 2020.
  7. Preventing tick bites on people. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/prev/on_people.html. Accessed Oct. 12, 2020.
  8. Rabbit from farm to table. U.S. Department of Agriculture. https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/meat-preparation/rabbit-from-farm-to-table. Accessed Oct. 12, 2020.
  9. Safe minimum internal temperature chart. U.S. Department of Agriculture. https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/safe-minimum-internal-temperature-chart/ct_index. Accessed Oct. 12, 2020.
  10. Preventing ticks on your pets. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/prev/on_pets.html. Accessed Oct. 12, 2020.


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