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L. H. Rutledge, M.D.
JAMA. 1927;88(11):788. doi:10.1001/jama.1927.92680370001006.
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This is the first case of tularemia to be reported in which the infection is known to have been derived in the state of Minnesota.

Mrs. J. H., aged 59, a housewife, of Detroit, Minn., cut her left thumb while dressing a rabbit, Aug. 21, 1926. The onset of symptoms occurred, August 27; the cut developed into an irregular ulcer which did not heal. A mild lymphangitis followed. One or two axillary glands were palpable and slightly tender; they were about the size of a large bean. The epitrochlear gland was slightly enlarged. A papulopustular skin eruption appeared in the second week and extended over the back, chest, abdomen and thighs. There were about two dozen pustules in all.

The clinical picture was much like that of typhoid. There was nausea, vomiting, headache, nosebleed, high fever, light chills, and extreme prostration.

Death occurred, September 9, on the fourteenth day of


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