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Plague

Douglas W. MacPherson, MD, MSc–CTM, FRCPC Reviewed 06/2019
 


BASICS

Plague is rare in most developed countries (1),(2)[C]. 
  • Except for pockets in the Southwest United States, endemic plague and transmission to humans is rare.

  • Plague outbreaks still occur in some ...

DIAGNOSIS

  • Because plague is rare in most regions of North America, a high level of clinical suspicion based on clinical presentation and exposure history is required for accurate and timely diagnosis.

  • ...

TREATMENT

  • Clinical treatment includes targeted antimicrobials and supportive care.

  • Implement appropriate infection-control and public health measures.

GENERAL MEASURES

  • Avoid creation of aerosol droplets.

  • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • CBC for hematologic toxicity of chloramphenicol

  • Aminoglycoside blood levels, if indicated

  • Clinical testing for antibiotic toxicity, if indicated

DIET

REFERENCES

1
Kwit N, Nelson C, Kugeler K, et al. Human plague—United States, 2015. MMWR Morb Mortal Wkly Rep.  2015;64(33):918–919. [View Abstract on OvidMedline]
2
Centers for Disease Control and P...

ADDITIONAL READING

  • Alvarez ML, Cardineau GA. Prevention of bubonic and pneumonic plague using plant-derived vaccines. Biotechnol Adv.  2010;28(1):184–196. [View Abstract on OvidMedline]

  • Feodorova ...

CODES

ICD10

  • A20.9 Plague, unspecified

  • A20.0 Bubonic plague

  • A20.2 Pneumonic plague

  • A20.7 Septicemic plague

  • A20.1 Cellulocutaneous plague

  • A20.3 Plague meningitis

  • A20.8 Other forms of plague

ICD9

  • 020.9 Plague, un...

CLINICAL PEARLS

  • Bubonic plague is endemic to the Southwestern United States.

  • Do not delay treatment in cases of suspected primary pneumonic plague while awaiting laboratory confirmation.

  • Alert public he...

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