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Pneumonia Caused by Yersinia pestis: Plague Pneumonia

  • Dennis James Cleri
  • Randy Marton
  • Mohammed Rabbat
  • John Vernaleo
Chapter

Summary and Conclusions

The number of plague cases reported to the World Health Organization is increasing every year. Plague epidemics have appeared in Malawi, Mozambique, and India, where they have not been seen in decades, andenzootic foci are increasing, including the increasing number of states in the United States reporting human disease (Galimand et al., 1997). Early diagnosis, isolation, rapid antimicrobial treatment and prophylaxis, and vector and animal reservoir control are the foundations for epidemic control. With the first reported case of multidrug-resistant Y. pestis from an epidemic area, the future of treatment and prophylaxis regimens may be problematic, although quinolones and third-generation cephalosporins may hold some promise.

Plague, and especially plague pneumonia, in their early presentations are difficult to diagnose. One must maintain a high index of suspicion and be sure to accurately assess a patient’stravel and vector or animal exposure when choosing presumptive therapy for a presumed bacterial pneumonia. A disease that may present itself as a pneumonia, adult respiratory distress syndrome, a surgical abdomen, undifferentiated sepsis with or without DIC, Reye’s syndrome, or any form of lymphadenopathy with or 0. without the above presentations is a diagnostic and treatment challenge. This is especially true in patients with plague pneumonia, where often there will be no second chance at therapy if empiric therapy fails.

Untreated, the disease is fatal in 90% to 95% of cases. Appropriate treatment reduces mortality to 5% to 18% (Cleri et al., 1997).

Keywords

Yersinia Enterocolitica Rift Valley Fever Systematic Bacteriology Yersinia Pestis Francisella Tularensis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Dennis James Cleri
    • 1
  • Randy Marton
    • 2
  • Mohammed Rabbat
    • 2
  • John Vernaleo
    • 3
  1. 1.Internal Medicine ResidencySt. Francis Medical CenterTrenton
  2. 2.St. Joseph’s Hospital and Medical CenterPaterson
  3. 3.Western Queens Community HospitalAstoria

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