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Tularemia following a squirrel bite in Southern Germany: a case report
Camilla Hahn1,2, Elias Walter3, Daniela Jacob4
1Institute of Tropical Medicine, University of Tübingen, Wilhelmstr. 27, 72074, Tübingen, Germany. Camilla.hahn@med.uni-tuebingen.de.
Infection
|January 23, 2026
Summary
Tularemia, a zoonotic infection caused by Francisella tularensis, can be transmitted through squirrel bites. Early fluoroquinolone therapy led to a full recovery in a patient diagnosed with tularemia following a squirrel bite in Germany.
Area of Science:
- Infectious Diseases
- Zoonotic Infections
- Microbiology
Background:
- Tularemia is a zoonotic disease caused by Francisella tularensis, with increasing human cases in Germany.
- Exposure to hares or ticks are common sources of infection.
- Transmission via squirrel bites is rare, with only one prior report in Germany.
Purpose of the Study:
- To report a case of tularemia transmitted by a squirrel bite in Germany.
- To highlight the clinical presentation and diagnostic process.
- To emphasize the importance of considering tularemia in patients with relevant exposure history.
Main Methods:
- A case study of a 23-year-old woman bitten by a red squirrel in southern Germany.
- Clinical symptoms, diagnostic procedures (serology), and treatment were documented.
- Follow-up seroconversion confirmed the diagnosis of tularemia.
Main Results:
- The patient presented with symptoms including headache, chills, fatigue, and axillary lymphadenopathy.
- Francisella tularensis serology confirmed the diagnosis after initial negative results.
- Full recovery was achieved with a 10-day course of ciprofloxacin.
Conclusions:
- This case highlights squirrel bites as a potential transmission route for tularemia in endemic areas.
- Early diagnosis and fluoroquinolone treatment are associated with a favorable clinical outcome.
- Clinicians should consider tularemia in patients presenting with relevant symptoms after rodent bites.
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