Report on five cases of tularaemic pneumonia in a tularaemia outbreak in Spain

A report is given on five cases of atypical tularaemic pneumonia selected f rom among 140 cases of tularaemic infection in a previously reported outbre ak occurring in 1997. Prior to this outbreak no human cases of tularaemia h ad been reported in Spain. All cases were diagnosed serologically. All five patients reported on here had a mild form of the disease, which was treate d successfully with streptomycin in four cases and ciprofloxacin in one cas e. Tularaemic pneumonia should be considered in the differential diagnosis of atypical pneumonia in Spain, especially in hunters and other persons who handle animal carcasses.