Tularemia Takes a Tropical Turn: A Rare Case of Typhoidal Tularemia in Florida.
Leandra Belmonte, Jamie Y Johnson, Kristin Cuthbert et al.
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Case in brief
A 36-year-old man in Florida with no significant medical history or recent travel had six months of fevers, malaise, rigors, fatigue, night sweats, and unintentional 30-pound weight loss. His broad, nonspecific illness initially raised consideration of infectious, rheumatologic, and malignant causes. Further history revealed that he hunted deer and wild turkey; testing showed positive Francisella tularensis IgM, supporting tularemia, suspected to have been tick-borne. He received levofloxacin 750 mg daily for 14 days, and his febrile episodes resolved within seven days of starting antibiotics.
What made this case unusual
The case combined a typhoidal, nonspecific presentation with no recent travel in Florida, where tularemia is uncommon, making the diagnosis easy to overlook.
Diagnostic / clinical pearl
In prolonged, unexplained febrile illness, targeted exposure history—including hunting and possible tick exposure—can prompt testing for tularemia even in regions where it is uncommon.