Clinical Syndromes and Pathology in Humans

  • Thomas Butler
Part of the Current Topics in Infectious Disease book series (CTID)


Although plague infection of man can assume many and protean clinical forms, the most common presentation, bubonic plague, in its typical clinical picture is so distinctive that both physicians and patients in endemic areas have little difficulty recognizing this disease. During an incubation period of 2–8 days following the bite of an infected flea, bacteria proliferate in the regional lymph nodes. Patients are typically affected by sudden onset of fever, chills, weakness, and headache. Usually at the same time, after a few hours, or on the next day, patients notice the bubo, which is signaled by intense pain in one anatomic region of lymph nodes, usually the groin, axilla, or neck. A swelling evolves in this area that is so tender that the patients typically avoid any motion that would provoke tenderness of the affected lymph nodes. For example, if the bubo is in a femoral area, the patients will characteristically flex, abduct, and externally rotate the hip to relieve pressure on the area and will walk with a limp. When the bubo is in an axilla, the patients will abduct the shoulder or hold the arm in a splint. When a bubo is cervical in location, patients will tilt their heads to the opposite side. This extreme tenderness of the buboes naturally causes patients to resist physicians’ attempts to palpate and aspirate their buboes.


Mesenteric Lymph Node Yersinia Enterocolitica Erythema Nodosum Yersinia Pestis Affect Lymph Node 
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Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Thomas Butler
    • 1
    • 2
  1. 1.International Center for Diarrhoeal ResearchDhakaBangladesh
  2. 2.Case Western Reserve UniversityClevelandUSA

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