What is plague? Into directory a to z medical environment
Plague is an infection of rodents and I could pass to humans through the bite of infected fleas.
What causes it and how is it spread?
Plague is caused by bacteria. Yersinia (pasteurella) pestis, which is a small gram negative bacillus. This bacteria attacks the rodents (rats) and is transmitted from one to another by fleas, same can also infect humans. The plague bacillus grows in the gut of fleas obstructing it, that’s why when the flea sucks blood, it is regurgitated with microorganisms into the bite wound. You can also contaminate through their feces.
If a sick patient develops pneumonia, you may infect others through small droplets of saliva when coughing or sneezing.
The incubation period is two to 10 days.
The pathogenesis mark after microorganisms were inoculated via flea bite these are disseminated through the ducts to the lymph nodes, they grow considerably (bubo). A trip into the bloodstream and subsequently affect other organs. If there is pneumonia or meningitis, this disease usually ends with death.
The disease onset is usually sudden, with high fever, malaise, tachycardia, severe headache, and generalized myalgia (muscle pain). Delirium may occur and the patient is anxious. Pneumonia is accompanied by tachypnea, productive cough, blood-streaked sputum and cyanosis and there may be signs of meningitis.
The axillary and inguinal lymph nodes or cervical grow, become sensitive and ultimately may suppurate and drain. On the site of the bite can be a pustule or ulcer and signs of lymphangitis.
Fulminant pneumonitis accompanied by bloody sputum, frothy and sepsis, normally fatal in unimmunized unless you start treatment within a few hours of onset.
You can find the bacillus in gram stained smears or aspirates of buboes immunofluorescence. Cultures of material obtained from buboes usually grows very slowly so it is not practical.
From the radiological point of view, a patient who is suspected of plague is an infiltrator and indicates a poor prognosis and there are strict measures to isolate it.
Lymphadenitis of plague very often confused with the accompanying lymphadenitis or streptocócicas stafilocócicas infections or sexually transmitted diseases such as syphilis and lymphogranuloma venereum.
TREATMENTS AND RECOMMENDATIONS
When plague is suspected, it is necessary to confirm, you have to start treatment immediately with streptomycin 1 g IM and after 0.5 mg IM every six to eight hours. Simultaneously tetracyclines administered daily oral or parenteral 2gr if necessary. Maintain a permeable pathway, to administer fluids and pressor drugs. If necessary to administer oxygen and if necessary will be used tracheostomy.
We used vaccine against bubonic plague with live attenuated and killed, but the effectiveness is unknown.
People who are at risk of infection will be given prophylactic treatment based tetracycline hydrochloride at 500 mg oral once or twice daily for 5 days