Case 14 - Yersinia pestis (plague)

Case Sheet

Symptoms

Fever, weakness, pain in left groin, diarrhea, and a small rash on leg.

Case Sheet

Laboratory studies

Small hemorrhages on the skin of leg

Case Sheet

Diagnostic testing

Blood cultures and routine bacterial cultures of lymph node aspirates

Case Sheet

Treatment

Drug of choice: Streptomycin (not easily available in the U.S.)

Alternative drugs: gentamicin, tetracycline (doxycycline: also a choice for chemoprophylaxis), and chloramphenicol.

Untreated plague has a very high mortality rate so appropriate antibiotics should be given as soon as possible once cultures are obtained

Case Sheet

Prevention strategies

Patients with Y. pestis should be reported immediately to local or state health departments to enable prompt initiation of appropriate public health control and prevention activities.

May include rodent control, avoidance of contact with infected rodents, and insecticide in areas where the disease is prevalent or outbreaks occur.

During epidemics/sporadic cases, strict isolation with precautions against airborne spread is necessary

All contacts should be provided with chemoprophylaxis with tetracycline for 1 week

NO VACCINE AVAILABLE

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Structure of Pathogen

• Gram-negative

• Safety pin appearance

• Pleomorphic

• Bipolar-staining coccobacillus member of the Enterobacteriaceae family

• Obligate intracellular pathogen 

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Diagnostic Testing

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Vectors

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Pathogenicity Factos

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Immunity

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Receptors