Behind the COVID-19 Curtain: A Rare Case of Autochthonous Pneumonic Tularemia in Portugal

The presence of <i>Francisella tularensis</i> has been well documented in Portugal; however, reports of human infection remain rare. We report the case of a 63-year-old woman presenting with pneumonia and SARS-CoV-2 infection. The relapsing course of infection, partial response to fluoroquinolone and macrolide antibiotics, and epidemiological background led to the suspicion of an underlying zoonotic disease. Serology later confirmed <i>F. tularensis</i> infection, and the patient improved under directed therapy. To the best of our knowledge, this is the first case of autochthonous pneumonic tularemia reported in Portugal.