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Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)

Daniel J Sexton, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


The genus Yersinia includes 11 species, three of which are important human pathogens: Yersinia pestis, Yersinia enterocolitica, and Yersinia pseudotuberculosis. The yersinioses are zoonotic infections of domestic and wild animals; humans are considered incidental hosts that do not contribute to the natural disease cycle.

Y. pestis causes plague and is transmitted by fleas. The most common clinical manifestation is acute febrile lymphadenitis, called bubonic plague. Less common forms include septicemia, pneumonia, pharyngeal, and meningeal plague.

The clinical features, diagnosis, and treatment of plague will be reviewed here. The epidemiology, microbiology, and pathogenesis of Y. pestis are discussed separately. (See "Epidemiology, microbiology and pathogenesis of plague (Yersinia pestis infection)".)

Issues related to other Yersinia species are discussed separately. (See "Epidemiology of yersiniosis" and "Microbiology and pathogenesis of Yersinia infections" and "Clinical manifestations and diagnosis of Yersinia infections" and "Treatment and prevention of Yersinia enterocolitica and Yersinia pseudotuberculosis infection".)


Plague is a murine zoonosis; humans are incidental hosts. Humans acquire plague via bites of rodent fleas, scratches or bites from infected domestic cats, direct handling of infected animal tissues, inhalation of respiratory secretions from infected animals, inhalation of aerosolized droplets from infected humans, consumption of contaminated food, or by laboratory exposure [1-5]. The incubation period is generally two to eight days. (See "Epidemiology, microbiology and pathogenesis of plague (Yersinia pestis infection)".)

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Literature review current through: Nov 2017. | This topic last updated: Oct 24, 2017.
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