5 Types of Plague | Bubonic, Cellulocutaneous, Pneumonic, Meningitis, and Septicemic

Below we discuss five types of the plague; Bubonic plague, Cellulocutaneous plague, Pneumonic plague, Plague meningitis, and Septicemic plague.

1. Bubonic plague

Bubonic plague is a severe bacterial infection of the lymph nodes caused by the bacterium Yersinia pestis. It is typically acquired through the bite of infected fleas, contact with contaminated fluid or tissue, or inhaling airborne infectious droplets.

1.1 Symptoms

A patient with bubonic plague can experience;

• tender, swollen, and painful lymph nodes (buboes);
• fever and chills;
• headache; and
• muscle pain.

In severe cases, the patient may become extremely weak, go into shock, and even die, the mortality rate for untreated infections being as high as 50 to 60 percent.

1.2 Diagnosis

Laboratory blood, sputum, and pus tests from an infected lymph node or lymph node tissue can detect the Yersinia pestis bacterium; specific antibody tests for Y. pestis may also be performed.

1.3 Treatment

Treatment includes rehydration with oral or intravenous fluids and antibiotics; in case of complications, hospitalization may be required. Vaccination is available for healthcare workers and people who live or work in endemic areas but is not recommended for the general population.

2. Cellulocutaneous plague

Cellulocutaneous plague is a bacterial infection of the skin caused by the bacterium Yersinia pestis and is typically acquired through the bite of infected fleas, contact with contaminated fluid or tissue, or inhaling airborne infectious droplets.  

2.1 Symptoms

A patient with cellulocutaneous plague can experience;

• skin rash;
• fever and chills;
• headache; and
• muscle pain.

In severe cases, the tissue around the bite sites can become necrosed (die) or gangrenous and turn black (hence the name “black death”).

2.2 Diagnosis

Laboratory blood, sputum, and pus tests from an infected lymph node or lymph node tissue can detect the Yersinia pestis bacterium; specific antibody tests for Y. pestis may also be performed.

2.3 Treatment

Treatment includes antibiotics and, in case of complication, hospitalization. Vaccination is available for healthcare workers and people who live or work in endemic areas but is not recommended for the general population.

3. Pneumonic plague

Pneumonic plague, the rare but most serious form of plague, is a bacterial infection of the lungs usually secondary to bubonic plague, which is caused by the bacterium Yersinia pestis and typically acquired through the bite of infected fleas, contact with contaminated fluid or tissue, or inhaling airborne infectious droplets. 

3.1 Symptoms

A patient with pneumonic plague can experience;

• chest pain;
• fever, and chills;
• headache;
• body aches; and
• bloody sputum.

The patient may become extremely weak, shock, and even die in severe cases.

3.2 Diagnosis

Laboratory blood, sputum, and pus tests from an infected lymph node or lymph node tissue can detect the Yersinia pestis bacterium; specific antibody tests for Y. pestis may also be performed.

3.3 Treatment

Treatment includes antibiotics and hospitalization for respiratory support in case of complication.

Untreated pneumonic plague is always fatal. Vaccination is available for healthcare workers and people who live or work in endemic areas but is not recommended for the general population.

4. Plague meningitis

Plague meningitis is a severe bacterial infection causing inflammation of the meninges (protective membranes that surround the brain and spinal cord) caused by the bacterium Yersinia pestis entering the brain through the bloodstream. Y. pestis is typically acquired through the bite of infected fleas, contact with contaminated fluid or tissue, or inhaling airborne infectious droplets.

4.1 Symptoms

Plague meningitis is primarily seen in children. A patient with plague meningitis can experience;

• severe headaches;
• fever and chills;
• body aches; and
• fatigue;

The patient may become extremely weak, coma, and even die in severe cases.

4.2 Diagnosis

Laboratory blood, sputum, and pus tests from an infected lymph node or lymph node tissue can detect the Yersinia pestis bacterium; specific antibody tests for Y. pestis may also be performed.

4.3 Treatment

Treatment includes antibiotics; hospitalization may be required for severe cases. Vaccination is available for healthcare workers and people who live or work in endemic areas but is not recommended for the general population.

5. Septicemic plague

Septicemic plague is a severe bacterial infection of the blood caused by the bacterium Yersinia pestis. It is typically acquired through the bite of infected fleas, contact with contaminated fluid or tissue, or inhaling airborne infectious droplets.

5.1 Symptoms

A patient with septicemic plague can experience;

• flulike symptoms of headache;
• fever;
• chills;
• body aches;
• skin rash marked by tender;
• red nodules with white centers;
• diffuse intravascular coagulation with hemorrhaging into the skin;
• subcutaneous tissues; and
• organs and subsequent gangrene (death of tissues due to loss of vascular supply).

5.2 Diagnosis

Laboratory blood and sputum tests can detect the Yersinia pestis bacterium; specific antibody tests for Y. pestis may also be performed.

5.3 Treatment

Treatment includes antibiotics. In septicemic plague, the bacteria enter the bloodstream secondary to bubonic or pneumonic plague and multiply there; septicemic plague can be fatal within 24 hours of the appearance of symptoms if not quickly treated.

Vaccination is available for healthcare workers and people who live or work in endemic areas but is not recommended for the general population.