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| There are many diseases that resemble the basic [[signs]] and [[symptoms]] of bubonic plague. Since bubonic plague has the ability to kill the majority of a population, it is an extremely concerning diagnosis. It is very important to check for these other diseases before a final diagnosis of bubonic plague is made. There are many other [[bacterial]] [[infections]] that could be mistaken for the bubonic plague.
| | #Redirect [[Yersinia pestis infection differential diagnosis]] |
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| ==Differential diagnosis==
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| ===Bubonic plague===
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| *[[Streptococcal]] or [[staphylococcal]] [[adenitis]] (Staphylococcal aureus, Staphylococcal pyogenes)
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| **Purulent or inflamed [[lesion]] often noted [[distal]] to involved [[nodes]] (i.e., [[pustule]], infected traumatic lesion).
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| **Involved nodes more likely to be fluctuant.
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| **Associated ascending [[lymphangitis]] or [[cellulitis]] may be present (generally not seen with plague).
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| *[[Tularemia]] (Francisella tularensis)
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| **[[Ulcer]] or [[pustule]] often present distal to involved nodes.
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| **Clinical course rarely as fulminant as in plague.
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| **Systemic toxicity uncommon.
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| *[[Cat scratch fever]] (Bartonella henselae)
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| **History of contact with cats; usually history of cat scratch.
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| **Indolent clinical course; progresses over weeks.
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| **Primary lesion at site of scratch often present (small [[papule]], [[vesicle]]).
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| **Systemic toxicity not present.
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| *[[Mycobacterial infection]], including [[scrofula]] (Mycobacterium tuberculosis and other Mycobacterium species)
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| **With scrofula, [[adenitis]] occurs in [[cervical]] region.
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| **Usually [[painless]].
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| **Indolent clinical course.
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| **[[Infections]] with species other than M. tuberculosis more likely to occur in [[immunocompromised]] patients.
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| *[[Lymphogranuloma venereum]] (Chlamydia trachomatis)
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| **[[Adenitis]] occurs in the [[inguinal]] region.
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| **History of [[sexual]] exposure 10-30 days previously.
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| **Suppuration, fistula tracts common.
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| **Although LGV [[buboes]] may be somewhat [[tender]], exquisite tenderness usually absent.
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| **Although patients may appear ill ([[headache]], [[fever]], [[myalgias]]), systemic [[toxicity]] not present.
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| *[[Chancroid]] (Hemophilus ducreyi)
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| **Adenitis occurs in the inguinal region.
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| **Ulcerative lesion present.
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| **Systemic symptoms uncommon; toxicity does not occur.
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| *Primary [[genital herpes]]
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| **Herpes lesions present in genital area.
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| **Adenitis occurs in the inguinal region.
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| **Although patients may be ill (fever, headache), severe systemic toxicity not present.
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| *Primary or secondary [[syphilis]] (Treponema pallidum)
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| **Enlarged [[lymph nodes]] in the inguinal region.
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| **Lymph nodes generally painless.
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| **[[Chancre]] may be noted with primary syphilis.
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| *Strangulated inguinal [[hernias]]
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| **Evidence of bowel involvement.
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| ==Chest X Ray==
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| Some other infectious diseases can be differentiated by looking at chest x ray images. For example, [[SARS]], [[Hantavirus]] syndrome, and [[Anthrax]] all need to be ruled out because they do present with some similar [[Bubonic plague symptoms|Symptoms]]. An example of a chest x ray for Hantavirus and Anthrax is shown.
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| [[Image:Chest hantavirus.jpg|400 px|This chest x ray image is of a patient with Hantavirus syndrome]]
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| [[Image:Chest anthrax.jpg|This chest x ray image is of a patient with Anthrax]]
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| ==References==
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| {{Reflist|2}}
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