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1
Tularemia is a zoonotic infection caused by Francisella tularensis and can spread through infected arthropod bites, animal contact, inhalation, or contaminated food or water.
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2
Denmark reported 109 laboratory-confirmed tularemia cases from 2013 through 2024 and 32 cases in 2025 alone.
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3
Pediatric tularemia may be overlooked because fever and lymphadenitis resemble common bacterial infections and clinical suspicion is often low in low-incidence settings.
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4
Two Danish children with ulceroglandular tularemia were initially treated for presumed bacterial infection with beta-lactam antibiotics but did not improve.
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5
Persistent fever and regional lymphadenitis, particularly with an adjacent punched-out ulcer or failure of beta-lactam therapy, should prompt consideration of tularemia.
