Tularemia

March 1, 2005
W. B. Wadlington, MD

The rash of tick tularemia is seen here on the arm of a5-year-old boy. He also had a tick bite on his back that becamenecrotic and ulcerated. His axillary lymph nodesbecame palpable within 2 weeks after the tick bite.

The rash of tick tularemia is seen here on the arm of a5-year-old boy. He also had a tick bite on his back that becamenecrotic and ulcerated. His axillary lymph nodesbecame palpable within 2 weeks after the tick bite.The diagnosis of ulceroglandular tularemia wasconfirmed by a blood agglutination titer of 1:4000. (Anagglutination titer greater than 1:80 is diagnostic, althoughoften the titer is not elevated during the firstweek.) The patient responded well to antibiotic therapy;the prognosis for tularemia is usually good.Ulceroglandular tularemia is the most commonform of tick tularemia. All forms provoke fever, chills,headache, and myalgia to varying degrees.

(Case and photograph courtesy of W. B. Wadlington, MD.)

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