Types of Tularemia

Ulceroglandular

Most common

Primary lesions on the hands or fingers with regional lymphadenitis

Typhoidal*

Common

Systemic illness without indication of the site of inoculation or localized infection

Oculoglandular

Uncommon

Conjunctivitis with inflammation of ipsilateral preauricular, submandibular, or cervical lymph nodes, probably caused by inoculation of an eye from an infected finger or hand

Glandular

Rare

Regional lymphadenitis but no primary lesion and often cervical adenopathy, suggesting oral ingestion of bacteria

Pneumonic†

Uncommon

Infiltrates with asymmetric hilar adenopathy, with or without bloody pleural effusion

Oropharyngeal

Rare

Sore throat and cervical adenopathy due to ingestion of contaminated food or water

Septicemic*

Rare

Severe systemic illness with hypotension, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation, and multiorgan dysfunction