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| __NOTOC__
| | #Redirect [[Yersinia pestis infection differential diagnosis]] |
| {{Bubonic plague}}
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| {{CMG}}
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| ==Overview==
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| Bubonic plague must be differentiated from other diseases that also cause smooth, painful [[lymph node swelling]] called a [[bubo]], [[chills]], [[malaise]] ([[not feeling well]]), high [[fever]], [[muscle pain]], [[headache]], and [[seizures]]. Since bubonic plague has the ability to spread in an epidemic fashion with a high mortality rate, it is an extremely grave diagnosis for both the patient and the population. Given the grave nature of bubonic plague, it is critical to exclude other diagnoses before a final diagnosis of bubonic plague is made.
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| ==Differentiating Bubonic Plague from other Diseases==
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| ===Bubonic Plague===
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| *[[Streptococcal]] or [[staphylococcal]] [[adenitis]] (''[[Staphylococcus aureus]]'', ''Staphylococcus 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]] (''[[Haemophilus 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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| ==References==
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| {{Reflist|2}}
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| [[Category:Bacterial diseases]]
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| [[Category:Infectious disease]]
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| [[Category:Epidemics]]
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| [[Category:Pandemics]]
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| [[Category:Zoonoses]]
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| [[Category:Insect-borne diseases]]
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| [[Category:Disease]]
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