Oropharyngeal tularemia refers to primary ulceroglandular disease confined to the throat. It produces an acute exudative or membranous pharyngotonsillitis with cervical lymphadenopathy. Pneumonic tularemia is an illness characterized primarily by pneumonia. Pneumonia is common in tularemia. The case fatality rate without treatment is approximately 5 percent for the ulceroglandular form and 35 percent for the typhoidal form.
All ages are susceptible, and recovery is followed by permanent immunity.
Isolation represents a clear hazard to laboratory personnel and should only be attempted in BL-3 laboratory. The diagnosis can be established retrospectively serologically. A fourfold rise in the tularemia tube agglutination or microagglutination titer is diagnostic of infection. Tetracycline and chloramphenicol treatment are effective as well, but are associated with significant relapse rates. It is given by scarification.