Yersinia pestis infection history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editors-In-Chief: Esther Lee, M.A.

Overview

The typical sign of the most common form of human plague is a swollen and very tender lymph gland, accompanied by pain. The swollen gland is called a "bubo." Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2 to 6 days after being infected.

History and Symptoms

The plague may have any of 3 classic presentations:

• Bubonic plague
• Septicemic plague
• Pneumonic plague

The following table compares the various types of plagues and their corresponding clinical features.

Bubonic Plague

• Incubation period of 2–6 days, when the bacteria is actively replicating.
• Universally a general lack of energy
• Fever
• Headache and chills occur suddenly at the end of the incubation period
• Swelling of lymph nodes resulting in buboes, the classic sign of bubonic plague. The inguinal nodes are most frequently affected ("boubon" is Greek for "groin.")

Septicemic Plague

• Hypotension
• Hepatosplenomegaly
• Delirium
• Seizures in children
• Shock
• Universally a general lack of energy
• Fever
• Symptoms of bubonic or pneumonic plague are not always present

Pneumonic Plague

• Fever
• Chills
• Coughing
• Chest pain
• Dyspnea
• Hemoptysis
• Lethargy
• Hypotension
• Shock
• Symptoms of bubonic or septicemic plague are not always present

References

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