Pulmonary Plague

Plague is a natural focal zoonosis of rodents caused by Yersinia pestis, transmitted to humans via infected rats/fleas under certain conditions. It has abrupt onset, severe course, high infectivity, and high fatality; clinically acute lymphadenitis is most common, followed by septicemic, pneumonic, meningeal, and cutaneous forms.

Common Symptoms

Hepatosplenomegaly; respiratory failure; diarrhea; dyspnea; cyanosis

Causes and Pathogenesis

Y. pestis is a Gram-negative coccobacillus in the family Enterobacteriaceae, genus Yersinia, non-motile, non-spore-forming, encapsulated, and facultatively anaerobic. It has F1 (capsular glycoprotein, highly specific, used in serodiagnosis), T (murine toxin toxic only to rodents; cell-wall LPS endotoxin causes fever, DIC, complement activation, and tissue injury), and V/W antigens (plasmid-mediated, virulence-associated, enabling intracellular survival in macrophages). It is sensitive to heat, drying, sunlight, and common disinfectants but tolerates cold, surviving >1 year in pus, sputum, and soil. Bacilli enter through skin, travel lymphatically to nodes causing primary hemorrhagic necrotizing lymphadenitis; toxins cause systemic toxemia; invasion of blood causes septicemia with shock and DIC; respiratory entry causes primary pneumonic plague with hemorrhagic bronchitis, necrotizing pneumonia, hemorrhagic necrotizing hilar lymphadenitis, and fibrinohemorrhagic pleurisy.

Treatment

Drug therapy, supportive therapy, symptomatic treatment

Preventive Measures

Report all suspected cases; pulmonary plague requires strict respiratory isolation until sputum-negative; control inter-rat plague; kill fleas; personal protection; residents of endemic areas and lab workers should be vaccinated 2 weeks before exposure (valid 1 year); contacts may receive chemoprophylaxis with streptomycin 1 g/day IM or sulfadiazine 4 g/day in 4 oral doses.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.