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Fulminant Yersinia Pestis Infection in a Known HIV-Positive Patient: A Case Report of Identification in Nigeria 2024

Vivian Gga Kwaghe1, Cyril Erameh2, Nankpah Godsave Vongdip1

  • 1University of Abuja Teaching Hospital, Federal Capital Territory, Nigeria.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 20, 2025
PubMed

Insights

A fatal Yersinia pestis (plague) infection case occurred in Nigeria, a non-endemic region. This highlights the risk of severe co-infection in immunocompromised individuals, even outside known plague areas.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Yersinia pestis is a highly virulent bacterium responsible for plague.
  • While plague foci are present in Africa, Nigeria is considered a non-endemic region with no recent reported cases.
  • Immunocompromised individuals, such as those with HIV, are at increased risk for severe infections.

Purpose of the Study:

  • To report a fatal case of Yersinia pestis infection in Nigeria.
  • To emphasize the importance of clinical suspicion for plague in non-endemic areas.
  • To highlight the risks associated with Yersinia pestis co-infection in immunocompromised patients.

Main Methods:

  • Case report describing a patient presenting to a tertiary health facility.
  • Clinical presentation and diagnostic workup of the Yersinia pestis infection.
  • Review of patient's medical history, including HIV status.

Main Results:

  • A fatal case of Yersinia pestis infection was confirmed in a known HIV-positive patient in Nigeria.
  • The patient presented with symptoms consistent with severe systemic infection.
  • This represents a rare occurrence in a region not historically associated with plague outbreaks.

Conclusions:

  • High clinical suspicion for Yersinia pestis is crucial, even in presumed non-endemic regions like Nigeria.
  • Co-infection with Yersinia pestis poses a significant threat to immunocompromised individuals.
  • This case underscores the need for preparedness and diagnostic capabilities for rare infectious diseases.

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