Infectious Diseases in Critical Care Medicine

Table 6

Assessing the Patient for Category A Agents (

Continued

)

Pathogen(incubation period)

Systemic symptoms

Central nervoussystem

Cardiorespiratory

Gastrointestinal

Skin and mucousmembranes

Miscellaneous

Subclinical plague

In endemic areas, the

prevalence ofpositive serologyrises by 10 fold inasymptomaticindividuals duringperiods of increaseddisease activity.

Plague pharyngitis

Plague bacillus has

been isolated fromthroat swabs ofasymptomaticpersons, but long-term carriage hasnot beendocumented.

Disease resembles

acute tonsillitisaccompanied byinflamed anteriorcervical nodes.

Pestis minor

Mild febrile illness with

local lymph-adenopathy.

Septicemic plague

(Pestis siderans)

Occurs in 26% of

cases of bubonicplague. Rapidlydeveloping diseaseand deterioration.

70% have GI

symptoms withsecondarysepticemic plague.

Plague meningitis

(appears betweenthe 9th and 17thday of bubonicplague)

Caused by spread

from septicemicdisease. Patientswith axillary buboesare at increased riskof developingmeningitis, but maypresent withoutlymph-adenopathy.

Kernig’s sign, seizures,

vestibulocerebellarsymptoms, coma.

446 Cleri et al.