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| __NOTOC__
| | #Redirect [[Yersinia pestis infection]] |
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| {{SK}} Septicaemic plague
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| ==Overview==
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| Septicemic plague is a deadly blood infection, one of the three main forms of [[Plague (disease)|plague]]. It is caused by ''[[Yersinia pestis]]'', a gram-negative [[bacterium]].
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| Like some other forms of [[gram-negative]] sepsis, septicemic plague can cause [[disseminated intravascular coagulation]], and is almost always fatal without treatment (the mortality rate in medieval times was 99-100 percent). Septicemic plague is the rarest of the three plague varieties; the other forms are [[bubonic plague|bubonic]] and [[pneumonic plague]].
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| ==Historical Perspective==
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| Septicemic plague was the least common of the three plague varieties that occurred during the [[Black Death]] from 1348 to 1350<ref>{{citation |url=http://www.historylearningsite.co.uk/black_death_of_1348_to_1350.htm |title=History Learning Site - Black Death of 1348 to 1350 |publisher=History Learning Site |accessdate=2011-06-06}}</ref> (the other two being [[bubonic plague]] and [[pneumonic plague]]). Like the others, septicemic plague spread from the East through trade routes on the Black Sea and down to the Mediterranean Sea.
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| Major port cities such as Venice and Florence were hit the hardest. The massive loss of working population in Europe following the Black Death, resulting in increased economic bargaining power of the serf labor force, was a major precipitating factor for the Peasants' Revolt of 1381.
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| == Pathophysiology ==
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| The disease is contracted primarily through the bite of an infected rodent or insect, but like bubonic plague can very rarely be contracted through an opening in the skin or by cough from another infected human. After initial infection, the bacteria multiply in the blood, causing [[bacteremia]] and severe [[sepsis]]. In septicemic plague, bacterial [[endotoxin]]s cause disseminated intravascular coagulation (DIC), where tiny blood clots form throughout the body, possibly resulting in [[ischemic]] [[necrosis]] (tissue death due to lack of circulation/ [[perfusion]] to that tissue).
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| DIC results in depletion of the body's [[clotting]] resources, so that it can no longer control bleeding. Consequently, there is bleeding into the skin and other organs, leading to red and/or black patchy rash and [[hemoptysis]]/ [[hematemesis]] (respectively coughing up or vomiting up of blood). There are bumps on the skin looking somewhat like insect bites; these are usually red, and sometimes white in the center.
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| ==Differentiating Septicemic Plague from other Diseases==
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| Septicemic plague should be differentiated from the following diseases:
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| *[[Meningococcemia]]
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| **More likely to have evidence of meningitis (but not always present).
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| *[[Septicemia]] caused by other Gram-negative bacteria.
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| **Underlying illness usually present.
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| ==Complications and Prognosis==
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| ===Complications===
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| * [[DIC]]
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| ===Prognosis===
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| Untreated, septicemic plague is usually fatal. Early treatment with antibiotics reduces the [[mortality]] rate to between 4 and 15 percent. People that contract this disease must receive treatment in at most 24 hours, or death is almost inevitable. In some cases, people may even die on the same day they contract it.
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| ==Diagnosis==
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| ===Symptoms===
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| The usual symptoms are:<ref>
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| {{citation|url=http://www.nlm.nih.gov/medlineplus/ency/article/000596.htm|title=Medline Plus - Plague|publisher=NIH|accessdate=2011-03-24}}
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| </ref>
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| *[[Abdominal pain]]
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| *[[Bleeding]] due to blood clotting problems
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| *[[Diarrhea]]
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| *[[Fever]]
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| *[[Low blood pressure]]
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| *[[Nausea]] and [[vomiting]]
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| *Organ failure
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| However, septicemic plague may cause [[death]] before any symptoms occur.
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| ===Physical Examination===
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| ====Skin====
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| * [[Bumps on skin]]
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| ==Related Chapters==
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| *[[Septicemia]]
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| *[[Meningococcemia]]
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| *[[Bubonic plague]]
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| *[[Pneumonic plague]]
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| *[[Black Death]]
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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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| [[Category:Needs content]]
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| {{WH}}
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| {{WS}}
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