Ulceroglandular tularemia presents with a local ulcer and regional lymphadenopathy, fever, chills, headache and malaise. Typhoidal tularemia presents with fever, headache, malaise, substernal discomfort, prostration, weight loss and a non-productive cough.
Physical findings are usually non-specific.
Chest x-ray may reveal a pneumonic process, mediastinal lymphadenopathy or pleural effusion. Routine culture is possible but difficult. The diagnosis can be established retrospectively by serology. A live, attenuated vaccine is available as an investigational new drug. It is administered once by scarification.