Ulceroglandular tularemia, which is the most common form and makes for 80% of patients, starts with the infected suppurative skin lesion, most commonly the hands, and localized lymphadenopathy. The original skin lesion erupts and ulcerates with raised edges. Glandular tularemia in confined to lymphadenopathy [47] . Oculoglandular tularemia ensues after inoculation of the organism through the conjunctiva, with painful conjunctivitis, and preauricular, submandibular, and cervical lymphadenopathy. Oropharyngeal tularemia occurs after consuming contaminated food, with painful exudative pharyngitis and tonsillitis [44, 45, 47] . Pneumonic tularemia is similar to an atypical pneumonia with abrupt onset of constitutional symptoms and a nonproductive cough [48] .