Tularemia in a Psoriasis Patient on Biologic Therapy After Relocation to Western South Dakota.

It is important that clinicians recognize the geographical dimension in infectious disease risk for immunosuppressed individuals. The patient's experience with tularemia following her relocation from eastern to western South Dakota highlights how geographic transitions can introduce new infectious exposures and risks. For patients on immunosuppressive therapies, healthcare providers must consider potential infections endemic to the new region and adopt proactive management strategies. Early recognition, targeted therapy, and adjustments in immunosuppression are critical in managing such cases effectively. This case illustrates the importance of detailed travel histories, patient education, and coordination between specialists to ensure comprehensive care and optimal outcomes for immunocompromised patients in new environments.