Internal Medicine

bubonic plague

definition

The plague, earlier "black Death"Called, is a highly contagious infectious disease. There are two forms, bubonic plague and pulmonary plague. At around 90%, bubonic plague is the most common form of plague.

The bacterium Yersinia pestis is responsible for the disease. The bubonic plague got its name because of a characteristic symptom: there is massive swelling of the lymph nodes, so-called Peustbeulen (Bubo).

Bubonic plague pathogen

The causative agent of the bubonic plague is the bacterium Yersinia pestis. It is a gram-negative stick that belongs to the Yersinia family. Yersinia pestis is pleomorphic, which means that the bacterium can take on various shapes, but mostly it is oval. The bacterium has no flagella and is immobile. Depending on the temperature, it forms a capsule, for example at 37 ° C, while no capsule is formed at cooler temperatures.

Temperatures between 22 and 28 ° C are ideal for the Yersinia. In this temperature range the germs can multiply extremely well. A special feature compared to other Yersinia is that Yersiniae pestis are able to break down urea.

Yersinia can survive in saliva, feces and pus for several months. They are often found in rodent caves or dried up in fleas or ticks. In the human body they also have different possibilities to multiply, both inside and outside the cell.

Yersinia pestis is mainly transmitted by rodents such as mice and rats. Sometimes it is transmitted via parasites such as fleas or ticks, which ingest the pathogen when they feed on infected blood from a rat. The bubonic plague bacterium can be transmitted to humans by the parasites or rodents themselves. Most commonly, the bubonic plague is transmitted to humans through flea bites.

Find out more at. Germs and pathogens

These symptoms can be used to recognize the bubonic plague

The first symptoms of bubonic plague usually show up two to six days after being infected with the bacterium. This includes:

High fever
Headache and body aches
chills
dizziness
Feeling sick and weak
Plague bumps

In the area of the flea bite or the infection site, the lymph vessels and lymph nodes become inflamed. The inflamed lymph nodes swell and form very painful bumps (Plague bumps, bubons) out. The plague bumps can be up to ten centimeters in size. The purulent plague bumps can lead to an ulcer if left untreated.

Learn more at: Enlarged lymph nodes

The plague bumps can even affect the blood vessels, which means that the bacteria get into the bloodstream. If this happens, dangerous blood poisoning (sepsis) can result. The pathogens can spread through the bloodstream from other organs and, for example, cause meningitis (Plague meningitis) or pneumonia in the lungs.

The pathogens can cause the skin to bleed all over the body and eventually the skin to die. The fingers, toes and nose are mostly affected. These symptoms explain the earlier name of the plague, "black death".

Symptoms on the lungs

In bubonic plague, the lungs are not primarily affected, in contrast to pulmonary plague. However, if left untreated, the bubonic plague can spread the bacteria in the blood. Then the Yersinia have the opportunity to get into the lungs and cause pneumonic plague. Those affected cough up phlegm and often suffer from shortness of breath. Cough, blue lips, chills and fatigue are classic symptoms. Vomiting is also possible due to a pronounced urge to cough.

How contagious is the bubonic plague?

The plague is very contagious and therefore belongs to the quarantine diseases. Those affected by plague must be isolated, as well as people who have had contact with plague sufferers. It is transmitted from infected animals, fleas, ticks and other parasites to humans and from person to person. If pulmonary plague occurs as part of the bubonic plague, this means that the plague bacteria can even be transmitted through droplet infection, i.e. through coughing or wet speech by sick people. The bubonic plague is therefore a particularly highly contagious disease.

Treatment of bubonic plague

The bubonic plague is a disease caused by bacteria and must therefore be treated with antibiotics. The therapy consists of tetracyclines, suflonamides, quinolones, co-trimoxazole and spreptomycin. The antibiotic chloramphenicol, a so-called reserve antibiotic, is used for pest meningitis. There is a good chance of recovery if treated early.

Diagnosis of the Beuelenpest

The diagnosis of a bubonic plague is based on the clinical symptoms of the sick person and a pathogen detection. The pathogen Yersinia pestis can be detected by taking samples of blood, saliva or plague bumps. The pathogen can be seen under a microscope or grown in a culture.

Prognosis for the bubonic plague

The chances of recovery are very good if the bubonic plague is treated early. If those affected take effective antibiotics quickly, the number of deaths drops to one to five percent.

If you take the antibiotics later than 15 hours after the outbreak of the bubonic plague, the prognosis is significantly worse. Without any treatment, the bubonic plague leads to the death of almost 100% of those affected by complications such as pulmonary plague and plague sepsis. It is therefore extremely important to diagnose bubonic plague early and to treat it immediately with the right antibiotics.

Course of disease

The course of the disease in bubonic plague is heavily dependent on the form in which the disease occurs.

The majority of cases start suddenly, violently and progressively. Without proper antibiotic therapy, the bacteria can enter the bloodstream and cause plague sepsis. Pulmonary plague or plague meningitis can develop and be life-threatening.

In addition, lighter gradients are possible. The abortive plague is a mild form of the disease. Those affected usually only suffer from a low fever and slight swelling of the lymph nodes. This only forms a plague bump, if at all.