{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:44:05Z","timestamp":1782924245854,"version":"3.54.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Tularemia is a zoonotic infection caused by\n                      <jats:italic>Francisella tularensis<\/jats:italic>\n                      . Human cases in Germany are emerging and are usually associated with hare or tick exposure. Transmission via squirrel bites has only been reported once before in Germany.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We describe a 23-year-old woman who developed tularemia 11\u202fdays after being bitten by an injured red squirrel (\n                      <jats:italic>Sciurus vulgaris<\/jats:italic>\n                      ) in southern Germany. Initial symptoms included headache, chills and fatigue, followed by painful right axillary lymphadenopathy without fever. Empirical ciprofloxacin (500\u202fmg twice daily) was initiated on day\u202f10 post-bite.\n                      <jats:italic>Francisella<\/jats:italic>\n                      \u00a0\n                      <jats:italic>tularensis<\/jats:italic>\n                      serology was negative at presentation but seroconversion was documented 19\u202fdays later, confirming the diagnosis. The patient recovered fully after a 10-day course of ciprofloxacin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case underscores the need to consider tularemia after rodent bites in endemic areas, including squirrel bites, and highlights the favourable clinical course following early fluoroquinolone therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-025-02723-5","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T03:47:20Z","timestamp":1769226440000},"page":"1599-1601","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tularemia following a squirrel bite in Southern Germany: a case report"],"prefix":"10.1007","volume":"54","author":[{"given":"Camilla","family":"Hahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva-Maria","family":"Neurohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"B\u00e9lard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"2723_CR1","unstructured":"Robert Koch Institut. SurvStat@RKI 2.0. https:\/\/survstat.rki.de\/Default.aspx. Accessed 27 Oct 2025."},{"key":"2723_CR2","doi-asserted-by":"publisher","first-page":"210","DOI":"10.25646\/12213","volume":"2024","author":"Robert Koch Institut","year":"2022","unstructured":"Robert Koch Institut. Infektionsepidemiologische Jahrbuch meldepflichtiger Krankheiten f\u00fcr 2022. Robert Koch Institut 2024 p. 210. https:\/\/doi.org\/10.25646\/12213","journal-title":"Infektionsepidemiologische Jahrbuch meldepflichtiger Krankheiten f\u00fcr"},{"key":"2723_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8091448","author":"S Appelt","year":"2020","unstructured":"Appelt S, Faber M, K\u00f6ppen K, Jacob D, Grunow R, Heuner K. Francisella tularensis subspecies holarctica and tularemia in Germany. Microorganisms. 2020. https:\/\/doi.org\/10.3390\/microorganisms8091448.","journal-title":"Microorganisms"},{"key":"2723_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-022-03510-8","volume":"16","author":"HS Borgschulte","year":"2022","unstructured":"Borgschulte HS, Jacob D, Zeeh J, Scholz HC, Heuner K. Ulceroglandular form of tularemia after squirrel bite: a case report. J Med Case Rep. 2022;16:309. https:\/\/doi.org\/10.1186\/s13256-022-03510-8.","journal-title":"J Med Case Rep"},{"key":"2723_CR5","first-page":"123","volume":"8","author":"JS Magee","year":"1989","unstructured":"Magee JS, Steele RW, Kelly NR, Jacobs RF. Tularemia transmitted by a squirrel bite. Pediatr Infect Dis J. 1989;8:123\u20135.","journal-title":"Pediatr Infect Dis J"},{"key":"2723_CR6","doi-asserted-by":"publisher","first-page":"970","DOI":"10.7589\/JWD-D-20-00182","volume":"57","author":"SRR Pisano","year":"2021","unstructured":"Pisano SRR, Kittl S, Eulenberger U, Jores J, Origgi FC. Natural infection of a European red squirrel (Sciurus vulgaris) with Francisella tularensis subsp. holarctica. J Wildl Dis. 2021;57:970\u20133. https:\/\/doi.org\/10.7589\/JWD-D-20-00182.","journal-title":"J Wildl Dis"},{"key":"2723_CR7","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1017\/S0950268812001008","volume":"141","author":"A Kuehn","year":"2013","unstructured":"Kuehn A, Schulze C, Kutzer P, Probst C, Hlinak A, Ochs A, et al. Tularaemia seroprevalence of captured and wild animals in Germany: the fox (Vulpes vulpes) as a biological indicator. Epidemiol Infect. 2013;141:833\u201340. https:\/\/doi.org\/10.1017\/S0950268812001008.","journal-title":"Epidemiol Infect"},{"key":"2723_CR8","doi-asserted-by":"publisher","first-page":"678","DOI":"10.3201\/eid3104.240414","volume":"31","author":"S Nothdurfter","year":"2025","unstructured":"Nothdurfter S, Linde J, Sting R, Tomaso H, Heuner K, Meincke M, et al. Epidemiology of tularemia among humans and animals, Baden-Wuerttemberg, Germany, 2012-2022. Emerg Infect Dis. 2025;31:678\u201388. https:\/\/doi.org\/10.3201\/eid3104.240414.","journal-title":"Emerg Infect Dis"},{"key":"2723_CR9","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1017\/S0950268814002398","volume":"143","author":"G Hestvik","year":"2015","unstructured":"Hestvik G, Warns-Petit E, Smith LA, Fox NJ, Uhlhorn H, Artois M, et al. The status of tularemia in Europe in a one-health context: a review. Epidemiol Infect. 2015;143:2137\u201360. https:\/\/doi.org\/10.1017\/S0950268814002398.","journal-title":"Epidemiol Infect"},{"key":"2723_CR10","doi-asserted-by":"publisher","unstructured":"St\u00e4ndiger Arbeitskreis der Kompetenz- und Behandlungszentren f\u00fcr Krankheiten durch hochpathogene Erreger (STAKOB) beim Robert Koch Institut. Hinweise zur Therapie und Prophylaxe von Tular\u00e4mie. 2025. https:\/\/www.rki.de\/DE\/Themen\/Infektionskrankheiten\/Biologische-Gefahren\/STAKOB\/arbeitskreis-stakob-node.html, https:\/\/doi.org\/10.25646\/9147.2. Accessed 15 Nov 2025.","DOI":"10.25646\/9147.2"},{"key":"2723_CR11","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.512090","volume":"10","author":"M Maurin","year":"2020","unstructured":"Maurin M. Francisella tularensis, tularemia and serological diagnosis. Front Cell Infect Microbiol. 2020;10:512090. https:\/\/doi.org\/10.3389\/fcimb.2020.512090.","journal-title":"Front Cell Infect Microbiol"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02723-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-025-02723-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02723-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:45:41Z","timestamp":1782920741000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-025-02723-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["2723"],"URL":"https:\/\/doi.org\/10.1007\/s15010-025-02723-5","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"5 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of nnterests"}}]}}