Podcast 579:  Yersinia Pestis

<p><strong>Contributor: Don Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Yersinia Pestis is the bacteria that caused the black plague. It was first discovered to be the cause of the bubonic plague in 1800s in China during the 3rd bubonic plague where 10-20 million people died</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Causes 3 types of plague:</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Bubonic plague: characterized by severe swelling of lymph nodes called buboes, most commonly in the groin, also axillary and olecranon lymph nodes.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Septicemic plague: characterized by severe sepsis, no lymphadenopathy. This strain famously causes disseminated intravascular coagulopathy (DIC) and can lead to limb necrosis and fingers turning black. Hence the name the Black Death.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Pneumonic: most dangerous of the plagues and characterized by PNA on CXR with pronounced mediastinal lymphadenopathy </span></li> </ul> </li> <li style="font-weight: 400;"><span style="font-weight: 400;">Fleas are the largest reservoir, although prairie dogs and squirrels have been known to carry the bacteria as well.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Yersinia Pestis creates a microfilm inside the stomach of fleas and renders them incapable of digesting your blood when they try to eat it and they vomit the bacteria into your blood.</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Doxycycline and Ciprofloxacin are the mainstay of treatment.</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Achtman M, Zurth K, Morelli G, Torrea G, Guiyoule A. Carniel E. Yersinia pestis, the cause of plague, is a recently e