Clinical features and management of plague Custom Search Plague is an infections disease caused by a bacterium called Yersinia pestis. It primarily affects rodents but can be transmitted to humans by bites of fleas. The disease can be extremely serious with high mortality rate. The disease has caused pandemics in the past resulting in deaths of millions of people. Symptoms and signs of the disease: The disease can manifest in several forms. Bubonic form: After a short incubation period of less then a week the illness begins with abrupt onset of high fever, chills, vomiting and headache. There may be delirium or impaired level of consciousness. Occasionally the disease progresses gradually. There may not be any mark of flea bites. The regional lymph nodes (usually in the grain) are swollen and painful. Sometimes pus can collect inside the lymph nodes leading to rupture of the nodes and discharge of pus. The bacteria can enter the blood stream and cause septicemia. The bacteria produce a toxin which can damage blood vessels causing bleeding into skin. Inflammation of the muscles of the heart (myocarditis) can occur due to the toxin. Inflammation of lungs and meninges of brain are other complication. Septicemic form: The disease may manifest as septicemia without involvement of any lymph nodes. The prognosis for this form is worse than that of bubonic plague. The disease manifests with non specific symptoms like fever, chills, pain in muscles and poor appetite. Diagnosis may be delayed as it resembles any other febrile illness. Pneumonic form: Inhalation of the bacilli can manifest as pneumonic form of the disease. Transmission can occur from cats with pneumonic plague. It will also be the manifestation in case of release of the deadly bacilli in bio-terrorist attack. The disease manifests as fever cough, difficulty in breathing and blood tinged sputum. There may be associated vomiting with or without diarrhea. Lymph nodes in the neck may be swollen. Laboratory findings:The affected lymph nodes may be aspirated and examined under microscope. The bacteria can be recognized by its characteristic shape. Cultures may be positive within 2 days. Rising titer of the specific antibody may be demonstrated. Specific treatment: The bacteria usually respond to streptomycin 20-40 milligram per kilogram body weight per day or gentamycin 7.5 milligram per kilogram body weight per day in three divided doses. Children who are more than 9 years and are not very sick may be given Doxycyclin orally. Custom Search
Page last reviewed on 30th June 2010
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