Infectious Disease Compendium

Bubonic plague

Diagnosis

The three forms of plague are septic plague, pneumonic plague and bubonic plague.

Epidemiologic Risks

Y. pestis is found in burrowing rodents.

Microbiology

Y. pestis; purpuric (aka purpura fulminans) sepsis can also be caused by Capnocytophagia canimorsis, N. meningitis, and S. pneumoniae (especially in the asplenic).

Empiric Therapy

For historical reasons, in order of preference, streptomycin, tetracycline, and chloramphenicol are the recommended agents, however, I bet all aminoglycosides, doxycycline, tmp/sulfa piperacillin , quinolones and third generation cephalosporins will work, one of which most people will get for empiric sepsis anyway.

Pearls

An agent of bioterrorism, the Soviets probably bioengineered a strain to be resistant to antibiotics, which has also occurred naturally in Madagascar.

Rants

There is an interesting book "The Biology of Plagues" that makes a compelling argument that the black death of the middle ages was NOT due to Y. pestis. I was convinced.

ICD9 Codes (Soon to be supplanted by ICD10)

Bubonic plague 020.0.