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Plague

Douglas William MacPherson, MD, MSc(CTM), FRCPC Reviewed 06/2022
 


BASICS

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

  • Plague outbreaks still occur in some les...

DIAGNOSIS

  • A high level of clinical suspicion based on clinical presentation and exposure history is required for accurate and timely diagnosis.

  • Institute clinical infection control measures, laboratory...

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 Abstr...

ADDITIONAL READING

  • Drancourt M, Raoult D. Molecular history of plague. Clin Microbiol Infect. 2016;22(11):911–915. 

  • Fleck-Derderian S, Nelson CA, Cooley KM, et...

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

SNOMED

  • 58750007 Plagu...

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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