Oregon man's mysterious illness finally diagnosed as rare tularemia

After weeks of fevers, brain fog, and rapid weight loss, doctors at OHSU determined Andy McDonald's symptoms were caused by a bacterial infection contracted from rodents and wildlife.

Apr. 4, 2026 at 3:49pm

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Andy McDonald, a 54-year-old man from Clatskanie, Oregon, experienced a puzzling illness in the summer of 2022 that left him with fevers, brain fog, and rapid weight loss. After multiple hospitalizations and failed treatments, doctors at Oregon Health & Science University finally diagnosed him with pulmonary tularemia, a rare and potentially serious bacterial infection. The infection was likely caused by McDonald's exposure to rodents, skunks, and contaminated soil during home renovation projects.

Why it matters

Tularemia is an uncommon disease in the United States, with only 100-200 reported cases per year. This case highlights the importance of proper personal protective equipment when dealing with wildlife and emphasizes the challenges doctors can face in diagnosing rare or unusual illnesses, especially in immunocompromised patients.

The details

McDonald, who suffers from Crohn's disease, began experiencing fevers, chills, and mental fogginess in July 2022. Despite multiple trips to the emergency room and hospitalizations, doctors were initially unable to determine the cause of his symptoms. It wasn't until infectious disease specialist Dr. Tim Menza reviewed McDonald's recent exposures, including handling rodents, skunks, and dusty demolition work, that he suspected tularemia. Further testing confirmed the diagnosis, and McDonald was successfully treated with the antibiotic ciprofloxacin.

  • In July 2022, McDonald first experienced fevers and chills while driving to a county fair.
  • Over the previous year, McDonald had been exposed to untreated spring water, rodent droppings, and dust from demolition work on his home.
  • McDonald was hospitalized at OHSU in August 2022 for 10 days as doctors tried to determine the cause of his illness.

The players

Andy McDonald

A 54-year-old retired sawmill worker from Clatskanie, Oregon, who suffers from Crohn's disease and contracted a rare case of pulmonary tularemia.

Dr. Tim Menza

An infectious disease doctor formerly at OHSU and now at the University of Washington Medical School, who reviewed McDonald's case and determined the tularemia diagnosis.

Dr. Leah Werner

A primary care doctor and assistant professor of family medicine at OHSU who was part of the team caring for McDonald during his hospitalization.

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What they’re saying

“Nothing fit. It looked infectious, but didn't act like anything we knew.”

— Dr. Tim Menza, Infectious disease doctor

“Everyone thought he had lung cancer. We thought this patient was going to die.”

— Dr. Leah Werner, Primary care doctor

“It's great they figured it out. You just appreciate not feeling sick anymore.”

— Andy McDonald

What’s next

Doctors have advised McDonald to be more cautious when dealing with wildlife and to use proper personal protective equipment when working in dusty or contaminated environments to prevent future infections.

The takeaway

This rare case of tularemia highlights the challenges doctors can face in diagnosing unusual illnesses, especially in immunocompromised patients. It also underscores the importance of taking precautions when exposed to potential sources of bacterial infections, such as rodents and contaminated soil or water.