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Bubonic Plague (The Black Death) Presented by :Arif Khan Group 4 th Course 5th

Bubonic plague

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Page 1: Bubonic plague

 Bubonic Plague (The Black Death)

Presented by :Arif KhanGroup 4th

Course 5th

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It was known as the "Black Death" during the fourteenth century, causing an estimated 50 million deaths.

Plague is caused by the bacteria Yersinia Pestis( Enterobacteriaceae), a zoonotic bacteria, usually found in small animals and their fleas.

People infected with plague usually develop “flu-like” symptoms after an incubation period of 3-7 days.

Bubonic plague

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We now know that the most common form of the Black Death was the BUBONIC PLAGUE! This disease was spread by fleas which lived on the black rat. The fleas sucked the rat’s blood which contained the plague germs. When the rat died the fleas jumped on to humans and passed on the deadly disease.

How was the plague transmitted?

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What were the symptoms of the plague?

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The most infamous symptom of bubonic plague is an infection of the lymph glands (lymphadenitis), known as buboes, which become swollen and painful. After being transmitted via the bite of an infected flea, the Y. pestis bacteria become localized in an inflamed lymph node, where they begin to colonize and reproduce.

Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral, groin and neck region. Acral gangrene (i.e., of the fingers, toes, lips and nose) is another common symptom.

Signs and symptoms

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Bubonic plague symptoms appear suddenly, usually 2–5 days after exposure to the bacteria. Symptoms include:

Gangrene of the extremities such as toes, fingers, lips and tip of the nose.[6]

Chills General ill feeling (malaise) High fever (39 °C; 102 °F) Muscle cramps[7]

Seizures Smooth, painful lymph gland swelling called a bubo,

commonly found in the groin, but may occur in the armpits or neck, most often at the site of the initial infection (bite or scratch)

Pain may occur in the area before the swelling appears Skin color changes to a pink hue in some very extreme

cases

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Other symptoms include heavy breathing, continuous vomiting of blood (hematemesis), aching limbs, coughing, and extreme pain. The pain is usually caused by the decay or decomposition of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, lenticulae (black dots scattered throughout the body), delirium, and coma.

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Laboratory StudiesDiagnosis

Leukocytosis with a predominance of neutrophils is observed, and the degree of leukocytosis is proportional to the severity of illness.Peripheral blood smear shows toxic granulations and Dohle bodies.Thrombocytopenia is common, and levels of fibrin degradation products may be elevated.Serum transaminase and bilirubin levels may be elevated.Proteinuria may be present, and renal function test findings may be abnormal.Hypoglycemia may be observed.Twenty-seven percent to 96% of blood cultures are positive for Y pestis in patients with bubonic plague and septicemic plague.

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Wayson stain showing the characteristic "safety pin"

appearance of Yersinia pestis, the plague bacillus.

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Fluorescence antibody positivity is observed as bright, intense green staining around the cell wall of Yersinia pestis, the plague bacillus

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Nuclear imaging may help localize areas of lymphadenitis and meningeal inflammation.

Imaging Studies

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Several classes of antibiotics are effective in treating bubonicplague . These include  aminoglycosides suchas streptomycin and gentamicin, tetracyclines (especially doxycycline), and the fluoroquinolone ciprofloxacin. Mortality associated with treated cases of bubonic plague is about 1–15%, compared to a mortality of 40–60% in untreated cases.

People potentially infected with the plague need immediate treatment and should be given antibiotics within 24 hours of the first symptoms to prevent death. Other treatments include oxygen, intravenous fluids, and respiratory support. 

Treatment

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