![]() A combination of 2 antibiotics from different classes is recommended in severe disease, plague meningitis, and pregnant women.Start empiric antibiotic treatment for 10 to 14 days as soon as plague is suspected, before results of diagnosis tests are available.In all cases, rapid test for malaria in endemic regions (and antimalarial treatment if needed, see Malaria, Chapter 6).Rapid diagnostic test for detection of F1 capsular antigen of Y.Transportation of specimens in 0.9% sodium chloride requires a cold chain (failing that, a temperature below 30 ☌), triple packaging and UN3373 label. Collect pre-treatment specimens: lymph node aspirate (bubonic plague), sputum (pneumonic plague), blood (septicaemic plague), or cerebrospinal fluid (plague meningitis).Other causes of septicaemia (see Shock, Chapter 1) or meningitis (see Bacterial meningitis, Chapter 7).some bacterial skin infections, tularemia, lymphogranuloma venereum, chancroid) Plague meningitis is a rare but very severe form of plague.Septicaemic plague is a fulminant illness that can progress to disseminated intravascular coagulation, respiratory distress, shock, and death. ![]() ![]() Pneumonic plague can rapidly progress to respiratory distress, shock, and death without prompt treatment.The following forms of plague may be primary or secondary to bubonic plague: Without prompt treatment, the bacteria may be disseminated by haematogenous route, producing a more severe form (see below) with a high mortality rate. Natural foci of infection include Africa, Asia, North and South America, and parts of Europe.īubonic plague is the most common form, usually resulting from the bite of an infected flea. ![]() Plague is transmitted to man by infected animals (direct contact or inhalation of their respiratory secretions), the bite of a flea of infected animals, or inhalation of respiratory secretions of individuals with pneumonic plague. ![]() Plague is a zoonosis caused by the Gram-negative bacillus Yersinia pestis that affects many wild and domestic mammals, particularly rodents. ![]()
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