Since 1910, when Pearse1 published the first description of the clinical manifestations of tularemia, the number of cases reported annually has increased greatly. The disease is no longer considered a medical rarity. Owing largely to the work of the United States Public Health Service, the literature is replete with material on practically all the aspects of the condition. This presentation will therefore not embody the general considerations of the infection.
It has been said that the principal aid to the diagnosis of the condition is "to have the disease in mind." This is becoming even more necessary, because the constant additions to the lists of animal hosts and insect vectors have exploded the original idea that tularemia is limited to regions of the country where particular species of rodents and insects are found. Simpson,2 who has contributed and correlated much of the knowledge of the disease, was in
HITCH JM, SMITH DC. CUTANEOUS MANIFESTATIONS OF TULAREMIA. Arch Derm Syphilol. 1938;38(6):859–876. doi:10.1001/archderm.1938.01480180025003
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