Bubonic plague differential diagnosis: Difference between revisions

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There are many diseases that resemble the basic [[signs]] and [[symptoms]] of bubonic plague. Since bubonic plague has the ability to kill the majority of a population, it is an extremely concerning diagnosis. It is very important to check for these other diseases before a final diagnosis of bubonic plague is made. There are many other [[bacterial]] [[infections]] that could be mistaken for the bubonic plague.
#Redirect [[Yersinia pestis infection differential diagnosis]]
 
==Differential diagnosis==
 
===Bubonic plague===
*[[Streptococcal]] or [[staphylococcal]] [[adenitis]] (Staphylococcal aureus, Staphylococcal pyogenes)
**Purulent or inflamed [[lesion]] often noted [[distal]] to involved [[nodes]] (i.e., [[pustule]], infected traumatic lesion).
**Involved nodes more likely to be fluctuant.
**Associated ascending [[lymphangitis]] or [[cellulitis]] may be present (generally not seen with plague).
 
*[[Tularemia]] (Francisella tularensis)
**[[Ulcer]] or [[pustule]] often present distal to involved nodes.
**Clinical course rarely as fulminant as in plague.
**Systemic toxicity uncommon.
 
*[[Cat scratch fever]] (Bartonella henselae)
**History of contact with cats; usually history of cat scratch.
**Indolent clinical course; progresses over weeks.
**Primary lesion at site of scratch often present (small [[papule]], [[vesicle]]).
**Systemic toxicity not present.
 
*[[Mycobacterial infection]], including [[scrofula]] (Mycobacterium tuberculosis and other Mycobacterium species)
**With scrofula, [[adenitis]] occurs in [[cervical]] region.
**Usually [[painless]].
**Indolent clinical course.
**[[Infections]] with species other than M. tuberculosis more likely to occur in [[immunocompromised]] patients.
 
*[[Lymphogranuloma venereum]] (Chlamydia trachomatis)
**[[Adenitis]] occurs in the [[inguinal]] region.
**History of [[sexual]] exposure 10-30 days previously.
**Suppuration, fistula tracts common.
**Although LGV [[buboes]] may be somewhat [[tender]], exquisite tenderness usually absent.
**Although patients may appear ill ([[headache]], [[fever]], [[myalgias]]), systemic [[toxicity]] not present.
 
*[[Chancroid]] (Hemophilus ducreyi)
**Adenitis occurs in the inguinal region.
**Ulcerative lesion present.
**Systemic symptoms uncommon; toxicity does not occur.
 
*Primary [[genital herpes]]
**Herpes lesions present in genital area.
**Adenitis occurs in the inguinal region.
**Although patients may be ill (fever, headache), severe systemic toxicity not present.
 
*Primary or secondary [[syphilis]] (Treponema pallidum)
**Enlarged [[lymph nodes]] in the inguinal region.
**Lymph nodes generally painless.
**[[Chancre]] may be noted with primary syphilis.
 
*Strangulated inguinal [[hernias]]
**Evidence of bowel involvement.
 
==Chest X Ray==
Some other infectious diseases can be differentiated by looking at chest x ray images. For example, [[SARS]], [[Hantavirus]] syndrome, and [[Anthrax]] all need to be ruled out because they do present with some similar [[Bubonic plague symptoms|Symptoms]]. An example of a chest x ray for Hantavirus and Anthrax is shown.
 
[[Image:Chest hantavirus.jpg|400 px|This chest x ray image is of a patient with Hantavirus syndrome]]
 
[[Image:Chest anthrax.jpg|This chest x ray image is of a patient with Anthrax]]
 
==References==
{{Reflist|2}}

Latest revision as of 02:42, 26 July 2014