Signs and Symptoms

  • High Fever
  • Extreme Weakness
  • Glandular Swelling
  • Pneumonia
  • Hemorrhages in Skin and Mucous Membranes
  • Enlarged Painful Lymph Node
Initial signs and symptoms may be nonspecific with fever, chills, malaise, muscular pain, nausea, exhaustion, sore throat, and headache. This is bubonic plague, and it occurs more often in lymph nodes. The involved nodes become swollen, inflamed, and tender and may form or discharge pus. Fever is usually present. Untreated bubonic plague has a case-fatality rate of about 50 to 60 percent. Untreated primary septicemic plague and pneumonic plague are invariably fatal. Modern therapy markedly reduces fatality from bubonic plague; pneumonic and septicemic plagues also respond if recognized and treated early. However, patients who do not receive adequate therapy for primary pneumonic plague within 18 hours after onset of respiratory symptoms are not likely to survive.
Pneumonic plague begins with sudden onset of symptoms after an incubation period of 1-6 days. Symptoms include high fever, chills, headache, malaise, followed by cough (often with hemoptysis), progressing rapidly to dyspnea, stridor, cyanosis, and death. Gastrointestinal symptoms are often present. Death results from respiratory failure, circulatory collapse, and a bleeding diathesis. Bubonic plague is characterized by swollen painful lymph nodes called buboes (often in the inguinal area), high fever, and malaise. Bubonic plague may progress spontaneously to the septicemic form (septic shock, thrombosis, disseminated intravascular coagulation) or to the pneumonic form. Plague meningitis is also possible.
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