Plague

Diagnosis

If your doctor suspects plague, he or she may look for the Yersinia pestis bacteria in samples taken from your:

• Buboes. If you have the swollen lymph nodes (buboes) typical of bubonic plague, your doctor may use a needle to take a fluid sample from them (aspiration).
• Blood. You'll generally have Yersinia pestis bacteria present in your bloodstream only if you have septicemic plague.
• Lungs. To check for pneumonic plague, your doctor will take mucus (sputum) or fluid from your airways using a thin, flexible tube inserted through your nose or mouth and down your throat (endoscopy).

Treatment

Medications

As soon as your doctor suspects that you have plague, you'll need to be admitted to a hospital. You'll receive powerful antibiotics, such as:

• Gentamicin
• Doxycycline (Monodox, Vibramycin, others)
• Ciprofloxacin (Cipro)
• Levofloxacin
• Moxifloxacin (Avelox)
• Chloramphenicol

Preparing for your appointment

If you suspect you have plague, you're likely to start by going to an emergency room. You may eventually need to see a doctor specializing in infectious disease.

What you can do

If you have respiratory symptoms, you may need to wear a surgical mask to your appointment to help prevent spreading the disease to others. You might also want to:

• Tell your doctor about any relevant travel or possible plague exposures you've had.
• Write down any symptoms you're experiencing, including when they started.
• Write down key personal information, including whether you've recently traveled to an area where plague is common and whether you've handled wild animals.
• Make a list of all medications, vitamins or supplements you're taking.
• Bring a family member or friend along, if possible. Sometimes it can be difficult to retain all the information you get during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

For plague, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Other than the most likely cause, what are other possible causes for my symptoms or condition?
• What tests do I need?
• What is the best course of action?
• Will I need to be in isolation?
• What are the alternatives to the primary approach you're suggesting?
• I have other health conditions. How can I best manage them together?
• Are there any restrictions I need to follow?

Don't hesitate to ask any other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• When did you begin experiencing symptoms?
• Have you recently traveled to areas where plague is common?
• Have you recently handled wild animals or cats?
• Are you aware of having been bitten by fleas?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?