Localized cutaneous infection with Francisella tularensis resembling ulceroglandular tularemia in a cat

A chronically draining subcutaneous mass was removed from the ventral cervical region of a 6-year-old spayed female Domestic Shorthair cat. The histopathologic diagnosis was severe locally extensive pyogranulomatous and necrotizing cellulitis. Bacterial culture yielded Francisella tularensis subsp. tularensis as the causative agent. Immunohistochemical evaluation of sections for F. tularensis was negative. One year later, the cat was euthanized because of progressive lethargy found to be due to hypertrophic cardiornyopathy with pulmonary thromboembolism. No evidence of cutaneous or systemic infection by F. tularensis was found at necropsy. This case appears to be a localized form of tularemia resembling the ulceroglandular form of tularemia in humans and suggests that bacterial culture may be more sensitive than immunohistochemistry in detecting organisms in cases of localized F. tularensis infection.