Features depend on site of infection
All are associated with fevers
At risk patient groups include farmers, meat handlers, landscapers, veterinarians, hunters, sheep shearers and taxidermists.
Most common form, represents about 75% of disease
Present with a single erythematous ulcerative lesion with a central eschar
This represents direct inoculation from the insect bite or from handling infected animals
Lymphadenopathy
Usually inguinal or axillary
Cervical or occipital in children
This represents direct inoculation from the insect bite or from handling infected animals
Usually inguinal or axillary
Cervical or occipital in children
Regional lymphadenopathy with no skin lesions or ulceration
Most common presentation among children
Suppurated nodes may need drainage
From ingesting contaminated material
May cause outbreaks when water supply is disrupted
Symptoms include:
Sore throat,
Mouth ulcers
Exudative pharyngitis/tonsilitis
Cervical lymphadenitis
May cause outbreaks when water supply is disrupted
Sore throat,
Mouth ulcers
Exudative pharyngitis/tonsilitis
Cervical lymphadenitis
Associated with highest mortality rate
Results from direct inhalation of the bacterium into the lungs
Farmers and herders at higher risk
Acute infection associated with non-specific flu-like symptoms
Progresses to more severe pneumonic signs
Nodular infiltrates with pleural effusion on chest xray
Exudative effusion with lymphocytic predominance
May also be secondary to hematologic dissemination from other source
Farmers and herders at higher risk
Nodular infiltrates with pleural effusion on chest xray
Exudative effusion with lymphocytic predominance
Exudative effusion with lymphocytic predominance
Occurs with inocculation into eye (aerosols, rubbing with contaminated fingers, splash, etc.)
Pain, photophobia, tearing
May have small ulcers of the conjunctiva or periorbital erythema
May lead to corneal ulceration
May have preauricular, cervical or submandibular lymphadenopathy
May lead to corneal ulceration<unk>  that does not fit into any of the other groups
May present as sepsis
Often has associated GI symptoms
No skin lesions
May present as sepsis
Often has associated GI symptoms
No skin lesions
Tularemia
Babesiosis
Scabies
Colorado tick fever
Chancroid
Ehrlichiosis
Smallpox
Heartland virus