The goal of treatment is to cure the infection with antibiotics. Streptomycin and tetracycline are commonly used to treat this infection. Once daily gentamicin treatment has been tried with excellent results as an alternative therapy to streptomycin. However, because this is a rare disease, only a few cases have been studied to-date.
Tetracycline and chloramphenicol can be used alone, but they have a high relapse rate and are not considered a first-line treatment.
Note: Oral tetracycline is usually not prescribed for children until after all their permanent teeth have come in. It can permanently discolor teeth that are still forming.
Tularemia is fatal in about 5% of untreated cases, and in less than 1% of treated cases.
Call your health care provider if symptoms develop after a rodent bite, tick bite, or exposure to the flesh of a wild animal.
A vaccine is recommended for people at high risk (trappers, hunters, and laboratory workers who work with the bacteria).
Penn RL. Francisella tularensis (Tularemia). In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 227.
Schaffner W. Tularemia and other Francisella infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 332.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.