Symptoms

Most people exposed to tularemia who become sick generally do so within three to five days, although it can take as long as 21 days. There are several types of tularemia, and which type you get depends on how and where the bacteria enter the body. Each type of tularemia has its own set of symptoms.

Ulceroglandular tularemia

This is the most common form of the disease. Signs and symptoms include:

• A skin ulcer that forms at the site of infection — usually from 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, but without 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
• Sensitivity to light

Oropharyngeal tularemia

This form affects the mouth, throat and digestive tract. Signs and symptoms include:

• Fever
• Throat pain
• Mouth ulcers
• Abdominal pain
• Vomiting
• Diarrhea
• Inflamed tonsils
• Swollen lymph nodes in the neck

Pneumonic tularemia

This type of tularemia causes signs and symptoms typical of pneumonia:

• Dry 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 and chills
• Muscle pain
• Sore throat
• Vomiting and diarrhea
• Enlarged spleen
• Enlarged liver
• Pneumonia

When to see a doctor

If you think you may have been exposed to tularemia, see a doctor as soon as possible. This is especially true if you have been bitten by a tick or have handled a wild animal in an area where tularemia is found and have developed a fever, skin ulcers or swollen glands.