Case 211. Reference case 211A

　 　 　 　
　 Suppurative granulomas resemble tularemia histologically (HE). Langhans-type giant cells are evident. 　
　 　 　 　

　

 　 The final diagnosis of this case is unclear. Tuberculin reaction was negative. The clinical course was not aggressive. In Japan, tularemia is seen only in the northern part, but not in Shizuoka.