A 56-year-old male hunter presented with a painful, erythematous, and necrotic lesion on his left index finger, accompanied by fever and lymphadenopathy, after processing a wild boar carcass. Initial broad-spectrum antibiotics were ineffective. Diagnostic workup, including a biopsy and culture, identified Francisella tularensis, specifically the highly virulent type A strain, leading to a diagnosis of ulceroglandular tularemia. The patient was successfully treated with doxycycline. This case highlights the importance of considering zoonotic infections like tularemia in hunters presenting with characteristic skin lesions and systemic symptoms, especially after contact with wild animals.
Key note: Tularemia should be suspected in hunters with necrotic skin lesions and lymphadenopathy after wild animal exposure.