Bubonic plague differential diagnosis

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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.

Differentiating Bubonic Plague from other Diseases

Bubonic 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.
  • 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.

References


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