Plague diagnosis

Suggested Alternatives for Differential Diagnosis Abdominal aneurysm, aortic dissection, pleural effusion, subarachnoid hemorrhage, superior vena cava syndrome, hantavirus pulmonary syndrome, mediastinitis, fulminate mediastinal tumors pneumonia, gastroenteritis, meningitis, ecthyma, rat bite fever, spider bite, leprosy, plague, tularemia, coccidioidomycosis, diphtheria, glanders, histoplasmosis, psittacosis, typhoid fever, and rickettsial pox. 

Suggested Alternatives for Differential Diagnosis Psittacosis, Q fever, plague, diphtheria, tick-borne diseases, mycotic infections. 

Suggested Alternatives for Differential Diagnosis Plague and other septicemic diseases, acute pneumonia. 

Suggested Alternatives for Differential Diagnosis Other causes of pneumonia, typhoid fever, tuberculosis, plague, anthrax infection, smallpox. 

Suggested Alternatives for Differential Diagnosis Drug induced noncardiac pulmonary edema, acute respiratory distress syndrome, pneumonic plague, tularemia, Q fever, and viral influenza. 

Suggested Alternatives for Differential Diagnosis Acute respiratory distress syndrome, congestive heart failure, pulmonary edema, AIDS, pneumonia, cardiogenic shock, septic shock, phosgene toxicity, phosphine toxicity, salicylate toxicity with pulmonary edema, influenza, plague, tularemia, and anthrax. 

Suggested Alternatives for Differential Diagnosis Smallpox, pseudocowpox/paravaccinia, Varicella-zoster, tularemia, plague, parapox virus, Eczema herpeticum. 

Differential Diagnosis An epidemic of inhalation anthrax in its early stage with nonspecific symptoms could be confused with a number of viral, bacteria, and fungal infections. Progression over two to three days with sudden development of severe respiratory distress followed by shock and death within twenty-four to thirty-six hours in essentially all untreated cases eliminates diagnosis other than inhalation anthrax. Other diagnosis to consider would include aerosol exposure to staphylococcal enterotoxin B (SEB), plague, or tularemia pneumonia. 

Clinical Diagnosis A presumptive diagnosis can be made from by Gram or Wayson stain of lymph node aspirates, sputum, or cerebrospinal fluid. Plague can also be cultured. As for treatment, early administration of antibiotics is very effective. Supportive therapy for pneumonic and septicemic forms is required. 

Differential Diagnosis Q fever usually presents as an undifferentiated febrile illness, or a primary atypical pneumonia, which must be differentiated from pneumonia caused by mycoplasm, Tegionnaires disease, psittacosis or Chlamydia pneumoniae. More rapidly progressive forms of pneumonia may look like bacterial pneumonia including tularemia or plague. 

The diagnosis of cutaneous anthrax, likewise, is initially difficult. A history of skin contact with anthrax spores or potentially anthrax-contaminated animal products is helpful. In early stages, the skin lesion is very nonspecific, hut the later presence of a painless black eschar accompanied hy severe localized edema is essentially pathognomonic for the diagnosis. Other causes of painful lymphadenopathy such as staph, strep, plague, and tularemia may mimic cutaneous anthrax. Cutaneous anthrax lesions can also resemble the necrotic ulcerated lesions due to brown recluse spider bite. 

Respiratory Acute infection of the upper and /or lower respiratory tract Specific diagnosis of acute respiratory tract infection (RTI) Acute nonspecific diagnosis of RTI Acute nonspecific symptoms of RTI such as cough, shorfness of breafh Anthrax (inhaiationai) Tularemia Plague (pneumonic)... 

As with anthrax, early diagnosis of plague is critical and requires a high index of suspicion. In the United States, if only a small number of cases occur, physicians may overlook pneumonic plague for a couple of reasons. First, plague pneumonia... 

Table 2.10 Clinical presentation and diagnosis of pneumonic plague...

From 2004 to 2007, no cases of human plague were registered. Since 2006, the medical service has used a definition of cases of especially dangerous infection regulated by the Order of the Ministry of Health RK 623 (15.12.2006), in which stages of the diagnosis are subdivided into suspect, presumptive, and confirmed plague. 

Diagnosis of SEB intoxication may be difficult in the early stage because certain other diseases such as influenza, Q Fever, tularemia or plague may manifest similar symptoms. Treatment should include supportive care. Oxygenation, hydration and ventilator to help breathing may be needed in severe intoxication. Antibiotics may be effective. Currently there is no vaccine to protect humans from this toxin. 

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