(1) Signs/symptoms. This disease is an acute, usually fulminating disease in
which a primary local lesion in lymph nodes or lungs is either absent or so minor as to
The clinical picture is that of:
-- Severe septicemia (chills, fever, and prostration).
-- With extremely rapid deterioration of the patient's condition.
Untreated cases result in death within 2 to 3 days of the onset.
This form of the disease almost invariably appears in association with
bubonic plague cases.
e. Tonsillar Septicemic Plague. This form of the disease is actually a subtype
of bubonic plague contracted by inhalation of organisms rather than from a fleabite.
It consists of a primary localization in the Iymphoid tissue of the throat.
The local involvement may or may not attain sufficient size to be evident
The subsequent course may be that of either bubonic or primary
f. Diagnosis and Treatment. When plague occurs in its classical epidemic
form, the diagnosis is usually made on epidemiological and clinical grounds.
Considerably more difficulty may be encountered when sporadic cases occur.
Diagnosis is confirmed, using strict aseptic techniques, by demonstration
of Y. pestis in bubo contents or sputum, or by inoculating laboratory animals with these
Treatment with antibiotics must be initiated immediately upon suspicion of
-- The tetracyclines, chloramphenicol, and streptomycin are highly
-- The patient should be isolated and given bed rest with careful
medical and nursing care.