[Rapidly fatal septicemic plague secondary to undiagnosed primary bubonic plague: case report]

Area of Science:

• Infectious Diseases
• Bacteriology
• Public Health

Background:

• Plague, caused by Yersinia pestis, is a severe bacterial infection transmitted by fleas.
• Pneumonic plague represents the most lethal manifestation, and delayed diagnosis significantly increases mortality and disease spread.
• Effective control measures are hampered by late identification of plague cases.

Observation:

• A 42-year-old male presented with hyperpyrexia, hypotension, and inguinal adenopathy after traveling to a plague-endemic region.
• Despite characteristic symptoms, plague was not suspected until hospital admission.
• Treatment with antibiotics and intensive care commenced on the fifth day of illness.

Findings:

• The patient developed septic shock and respiratory failure, ultimately succumbing to the illness.
• Plague was confirmed retrospectively via polymerase chain reaction (PCR).
• The case underscores the challenge of recognizing plague in non-specialized settings.

Implications:

• A high index of suspicion for plague is crucial, especially in patients with relevant travel history and suggestive symptoms.
• Early diagnosis and prompt initiation of appropriate antibiotic therapy are vital for improving survival rates in plague patients.
• This case emphasizes the importance of continued vigilance and education regarding re-emerging infectious diseases like plague.