Yersinia pestis infection natural history, complications and prognosis: Difference between revisions
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Despite being a treatable disease, plague is still associated with a high case fatality rate, often attributable to late recognition and inappropriate antibiotic therapy. Untreated bubonic plague has a case fatality of rate 50-60%, with proper identification and prompt treatment the case fatality decreases to around 7%.<ref name="pmid20151494">{{cite journal| author=| title=Human plague: review of regional morbidity and mortality, 2004-2009. | journal=Wkly Epidemiol Rec | year= 2009 | volume= 85 | issue= 6 | pages= 40-5 | pmid=20151494 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20151494 }} </ref> Untreated septicemia or pneumonic plague is almost universally fatal if untreated early on. Even with proper therapy the latter may lead to mortality rates as high as 50%. <ref name="mendel">Dennis DT, Mead PS. Yersinia species, including plague. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Elsevier Churchill-Livingstone; 2009:chap 229.</ref> | Despite being a treatable disease, plague is still associated with a high case fatality rate, often attributable to late recognition and inappropriate antibiotic therapy. Untreated bubonic plague has a case fatality of rate 50-60%, with proper identification and prompt treatment the case fatality decreases to around 7%.<ref name="pmid20151494">{{cite journal| author=| title=Human plague: review of regional morbidity and mortality, 2004-2009. | journal=Wkly Epidemiol Rec | year= 2009 | volume= 85 | issue= 6 | pages= 40-5 | pmid=20151494 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20151494 }} </ref> Untreated septicemia or pneumonic plague is almost universally fatal if untreated early on. Even with proper therapy the latter may lead to mortality rates as high as 50%. <ref name="mendel">Dennis DT, Mead PS. Yersinia species, including plague. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Elsevier Churchill-Livingstone; 2009:chap 229.</ref> | ||
==Complications== | ==Complications== | ||
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|+'''''Complications of Yersinia pestis'''''<ref name="pmid16762739">{{cite journal| author=Koirala J| title=Plague: disease, management, and recognition of act of terrorism. | journal=Infect Dis Clin North Am | year= 2006 | volume= 20 | issue= 2 | pages= 273-87, viii | pmid=16762739 | doi=10.1016/j.idc.2006.02.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16762739 }} </ref> | |||
! style="background: #4479BA; width: 550px;" | {{fontcolor|Bubonic Plague}} | |||
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|style="padding: 5px 5px; background: #DCDCDC;" | | |||
*Septicemia | |||
*Pneumonia | |||
*Meningitis | |||
|- | |||
! style="background: #4479BA; width: 550px;" | {{fontcolor|Septicemic Plague}} | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC;" |*Black death: Gangrene of distal upper and lower extremities and tip of the nose due to small vessel thrombosis | |||
*Disseminated intravascular coagulopathy (DIC) | |||
*Adult respiratory distress syndrome (ARDS) | |||
*Meningitis | |||
*Pneumonia | |||
*Hepatic or splenic abscess | |||
*Endophthalmitis | |||
*Generalized lymphadenopathy | |||
|- | |||
! style="background: #4479BA; width: 550px;" | {{fontcolor|Pneumonic Plague}} | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC;" |*Septicemia | |||
*Abscess formation | |||
*Cavitation | |||
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|} | |||
<sup><center>Adapted from Koirala et al. Plague: disease, management, and recognition of act of terrorism. ''Infect Dis Clin N Am''.2006;20:273-87</center></sup> | |||
==References== | ==References== |
Revision as of 22:03, 25 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assistant Editors-In-Chief: Esther Lee, M.A.
Overview
If plague patients are not given specific antibiotic therapy, the disease can progress rapidly to death. About 14% (1 in 7) of all plague cases in the United States are fatal.
Prognosis
Despite being a treatable disease, plague is still associated with a high case fatality rate, often attributable to late recognition and inappropriate antibiotic therapy. Untreated bubonic plague has a case fatality of rate 50-60%, with proper identification and prompt treatment the case fatality decreases to around 7%.[1] Untreated septicemia or pneumonic plague is almost universally fatal if untreated early on. Even with proper therapy the latter may lead to mortality rates as high as 50%. [2]
Complications
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*Black death: Gangrene of distal upper and lower extremities and tip of the nose due to small vessel thrombosis
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*Septicemia
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References
- ↑ "Human plague: review of regional morbidity and mortality, 2004-2009". Wkly Epidemiol Rec. 85 (6): 40–5. 2009. PMID 20151494.
- ↑ Dennis DT, Mead PS. Yersinia species, including plague. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Elsevier Churchill-Livingstone; 2009:chap 229.
- ↑ Koirala J (2006). "Plague: disease, management, and recognition of act of terrorism". Infect Dis Clin North Am. 20 (2): 273–87, viii. doi:10.1016/j.idc.2006.02.004. PMID 16762739.