Clinical characteristics of a severe bubionic plague patient / 中华地方病学杂志

ABSTRACT

Objective:To understand the clinical manifestations and prognosis of severe bubonic plague, and to explore the treatment experience of severe bubonic plague.Methods:A retrospective analysis was conducted on the clinical data and treatment of a case of severe bubonic plague admitted to Huade County on November 11, 2019.Results:The case of bubonic plague was a 55-year-old male, and outbreak after hunting the hare at the foci. The clinical manifestations included fever, fatigue, left armpit skin hard, swelling, heat and pain, distinctness of lymph node enlargement in later stage, hiccups and pleural effusion. Laboratory tests showed diffuse intravascular coagulation (DIC), sepsis and multiple organ dysfunctions. Bubonic plague was confirmed by positive culture of Yersinia pestis and positive phage lysis test on the 3rd day after admission. After platelet, plasma, fluid resuscitation and streptomycin combined with moxixacin, DIC and multiple organ functions were restored to normal and the hard swelling subsided. The course of treatment lasted for 19 days, the body temperature returned to normal and the patient recovered. Conclusions:This patient is a severe case of bubonic plague characterized with lymphangitis, skin sclerosis and abnormal coagulation. Timely identification, evaluation, early and combined treatment is the key to successful treatment.