Infrequent manifestations of tularaemia in Sweden

Since 1931, when tularaemia was first recognized in Sweden, the annual incidence has varied widely. Except for a few cases, ulceroglandular and respiratory tularaemia have been the only forms of the disease observed. Here, cases from Sweden of oropharyngeal tularaemia and of tularaemia septicaemia and meningitis, are reviewed. Since the cases occurred outside manifest outbreaks, diagnostic difficulties were encountered and the diagnosis was reached more by chance than due to clinical suspicion. Possibly, cryptic cases of tularaemia may be more frequent than what appears from clinical reports.