Summary
Definition
History and exam
Key diagnostic factors
- residency in, or travel to, a plague-endemic area
- exposure to fleas or contact with infected animals
- constitutional symptoms
- lymphadenitis (bubonic plague)
- hemoptysis (pneumonic plague)
- diarrhea (yersiniosis)
- abdominal pain (yersiniosis)
Other diagnostic factors
- pleuritic chest pain (pneumonic plague)
- dyspnea (pneumonic plague)
Risk factors
- exposure to fleas (plague)
- exposure to people with plague (plague)
- residence in, or travel to, an endemic area (plague)
- contact with infected animals (plague)
- young children (yersiniosis)
- consumption of raw or undercooked pork products (yersiniosis)
- iron-overload syndromes (yersiniosis)
- chronic liver disease, diabetes, alcoholism (yersiniosis)
Diagnostic investigations
1st investigations to order
- blood culture (plague)
- bubo aspirate culture (bubonic plague)
- sputum culture (pneumonic plague)
- cerebrospinal fluid culture (septicemic plague)
- antigen detection (plague)
- WBC count (plague)
- CXR (pneumonic plague)
- stool culture (yersiniosis)
Treatment algorithm
Contributors
Authors

Consultant Infectious Diseases Physician
Department of Infection and Travel Medicine
The James Cook University Hospital
Middlesbrough
UK
Disclosures
JW declares that he has no competing interests.
Peer reviewers
Professor
Pathology/Microbiology and Immunology
University of Texas Medical Branch
Galveston
TX
Disclosures
VLM declares that he has no competing interests.
Associate Professor
Medical Director of Infection Control
Infectious Disease
Department of Medicine
SUNY Upstate Medical University
Syracuse
NY
Disclosures
WJ declares that he has no competing interests.
Consultant Microbiologist
Microbiology Department
Southern General Hospital
Glasgow
UK
Disclosures
AL declares that he has no competing interests.
Associate Professor of Medicine
Division of Infectious Diseases
Department of Internal Medicine
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JK declares that he has no competing interests.
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