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With bubonic plague, after a fleabite, there is a 2- to 6-day incubation period, at which time there is the sudden onset of fever, chills, weakness, and headache. Intense painful swelling occurs in the lymph nodes, usually in the groin, axilla, or neck. These swellings or buboes are typically oval in nature, 1 to 10 cm in diameter, and extremely tender. Up to 25% of patients will have pustules, papules, or skin lesions near these buboes. Without treatment, patients become septic, develop septic shock with cyanosis and gangrene in peripheral tissues, leading to the “black death” descriptor that was used during the pandemics in Europe. As mentioned, material from these buboes is infective only if inoculated into human tissue. However, patients who have bubonic plague can seed their lungs, in which case they develop pneumonic plague. Diagnosis is made with a Gram stain or culture of organisms from blood, sputum, or buboes. The treatment of choice is streptomycin, but chloramphenicol and tetracycline are 4251 acceptable alternatives. Patients with pneumonic plague should be managed as one would manage a patient with drug resistance to tuberculosis, because the respiratory secretions are highly infectious. Tularemia Francisella tularensis (tularemia) has some similarities to anthrax and plague, but is not nearly as dangerous. It was studied as a biologic weapon in the twentieth century because it is highly infectious, requiring an inoculum of perhaps as small as only ten organisms. The fact that both armies were infected underscores one of the dangers of using infectious agents as biologic weapons. Often these are dispersed with aerosols, and despite the best predictions of air currents, they are notoriously unpredictable; with the shifting air currents, one’s own troops could become infected. There are several animal hosts, with the cotton-tailed rabbit being one of the most susceptible. Normally, humans acquire tularensis through direct contact of an infected animal or from the bite of an infected tick or deerfly.

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10 of 10 - Review by J. Curtis
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Total customer reviews: 93