A 56-yr-old man was admitted for evaluation of fever, chills, jaundice, and alcoholic stools. Laboratory studies suggested a cholestatic process. Ultrasonography, computed tomography, and transhepatic cholangiography failed to reveal any abnormalities. Acute infection with Francisella tularensis was confirmed serologically, and a liver biopsy revealed cholestatic hepatitis with focal coagulative necrosis. Recovery was coincident with antibiotic therapy.