Tularemia

A patient with several days of fever, a skin ulcer, and enlarged regional lymph nodes may have more than a routine skin infection—especially after handling a wild animal or sustaining a tick or deer-fly bite. Tularemia is a zoonotic infection whose clinical form reflects how Francisella tularensis entered the body. The incubation period is 1–14 days, most often 3–5 days. The nurse's first high-value actions are to identify the exposure, recognize whether the illness is localized or systemic, alert the laboratory before specimens are sent, and ensure empiric therapy is not delayed. New respiratory failure, hypotension, altered mental status, or falling urine output changes the priority to urgent stabilization and escalation.