Francisella tularensis is a small, weakly staining, gram-negative cocco-bacillus, 0.2 by 0.2 to 0.7 um in size. It is non-motile, with a thick capsule, and is a facultative intracellular parasite: it undergoes phagocytosis but evades intracellular killing. Biovar F. tularensis, tularensis is found mainly in North America. Biovar F. tularensis, palaearctica is found primarily in Europe and Russia.

Clinical Manifestations of Aerosol Tularemia Infection
The most common forms of tularemia resulting from a BW (aerosol) attack will be typhoidal and pneumonic. Tularemic meningitis, gastrointestinal disease, and bacterial endocarditis may result from these forms of infection. However, these same complications could result from typhoidal or pneumonic forms as well. The incubation period is 2-5 days.
Symptoms of the Pneumonic form include fever, headache, muscle pain, difficulty to breath, short of breath, cough, and pleural pains. X-ray will reveal spotted infiltrates in lungs, lobular pneumonia, and pleural exudation. Symptoms of the Typhoidal form include fever without visible foci on skin and without lymphadenopathy - this form of disease could be very difficult to diagnose without collecting a thorough anamnesis.

Diagnosis and Treatment
Presenting Syndromes: Lymphadenitis and ulcers for ulceroglandular. Influenza like symptoms for Aerosol exposure: High Fever, Aches and Pains, enlarged lymph nodes.
Diagnostic Samples: Respiratory Secretions (pharyngeal wash, sputum), Blood (inconsistent recovery from blood)