Tularemia is a bacterial zoonotic disease that is caused by Francisella tularensis and among the infectious reasons that cause fever of unknown origin (FUO) in children. Typhoidal or pneumonic tularemia can manifest predominantly as FUO. However, presentation of oropharyngeal tularemia as FUO is uncommon. Here, we report a case of an 11-month-old infant with oropharyngeal tularemia presenting as FUO. To the best of our knowledge, this clinical presentation of oropharyngeal tularemia has not been previously reported in literature.
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