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Plague

Plague is caused by infection with the organism Yersinia Pestis. It is transmitted to man by domestic rats via the rat flea.

Clinical Manifestations

Incubation Period: 1 week.

Four clinical forms are recognized:

  1. Bubonic plague: Which usually presents with general symptoms of fever, malaise, vomitting. This is followed by lymph gland enlargement (bubos). The endotoxin of the bacteria leads to bleeding manifestations which may ultimately lead to shock.
  2. Pneumonic plague: A fumlinant form of pneumonia with bloody sputum.
  3. Stepticemic plague: Presents with shock and dissiminated intravascular coagulation.
  4. Cutaneous plague: Presents with a pulsatile eschar which later becomes necrotic and gangrenous.

Diagnosis

Examination of lymph node aspirates, sputum or blood films for Yersinia Pestis.

Treatment

Streptomycin is the antibiotic of choice. Supportive therapy for hypertension, shock, DIC.

 

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