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February 10, 2012

Plague (cont.)

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What are the symptoms and signs of plague?

The symptoms of plague can be progressive; however, most investigators break the symptoms into three different groups because plague is often described in three types; bubonic, septicemic, and pneumonic. A patient can also present with the symptoms of only one type of plague. Untreated plague may show progressive symptoms that can overlap; however, the following will describe those symptoms and signs that predominate during the three general types of plague:

  • Bubonic: In about three to seven days, lymph nodes become swollen, tender, and are termed buboes (the term bubonic is derived from buboes) and the patient may also develop fever, chills, and weakness.


  • Septicemic: In general, septicemic plague patients do not develop buboes; instead symptoms may include fever, chills, weakness, bleeding under the skin, abdominal pain, and septic shock with low blood pressure. Septicemic plague may develop in about one to seven days after exposure.


  • Pneumonic: In about one to three days after the person is exposed to airborne droplets that contain Y. pestis, shortness of breath, cough (sometimes with bloody sputum), and chest pain quickly develop along with weakness, fever, and headaches.

Untreated bubonic plague may progress and produce symptoms of both septicemic and pneumonic plague, while septicemic plague may progress to produce pneumonic plague. However, pneumonic plague is the most serious and lethal form of plague, and while the patient may develop septicemic symptoms, the pneumonic symptoms are the most serious. Nonetheless, all three plague types can be fatal to a patient.

Picture of an inguinal bubo in a patient with plague.
Figure 2: Picture of an inguinal bubo in a patient with plague. SOURCE: CDC/Dr. J. Lyle Conrad

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