A delay in diagnosis – Arizona man went a month without knowing he had the plague

Image source: BBC

Case of man diagnosed with plague almost a month after onset of symptoms

It is not always obvious that you are sick, sometimes the signs and symptoms can creep up on you. But you’re not sure whether you should bother your doctor with them. In any case, you should share your concerns with your doctor. Your doctor will be pleased to see you and relieved that you made the appointment. Listen to your body and go see a professional or else you’ll suffer like the man from Arizona who went nearly an entire month without knowing that he had contracted the plague. According to a new report, the plague can be quite deadly if not treated promptly. Although the man recovered, the case highlights the need for identifying infections caused by serious and potentially contagious pathogens, for example, Yersinia pestis, the bacterium that causes plague.

The 67-year-old first presented to the emergency room on June 18th, 2020, with complaints of dehydration, nausea, and weakness. According to the case report, doctors treated him with IV fluids and discharged him shortly after. However, he returned the next day with three painful red bumps on his legs that he thought were bug bites. At this point, the doctors suspected that he may have cellulitis, a skin infection caused by bacteria. He was also prescribed two antibiotics and sent home.

The Arizona man again returned the next day with more serious symptoms, including, fever, dizziness, chills and “swollen glands”. Doctors admitted him for sepsis and treated him with antibiotics. He tested negative for COVID-19.

His blood sample was sent to a commercial laboratory for identifying the cause of his infection

On June 30th, 2020, the man tested positive for Yersinia pseudotuberculosis, a bacterium that can spread from animals to humans, moreover, presents with fever and abdominal pain. In some cases, it may also present with a rash and a blood infection. The patient’s symptoms were closely related to Yersinia pestis. Doctors started him on a 2-week course of antibiotic vancomycin and discharged from the hospital on July 1st, 2020.

On July 10th, the doctors sent his blood sample to Arizona State Public Health Laboratory and Y. pestis was identified in the sample. Plague is a vector-borne disease caused by Y. pestis. Health officials confirmed the diagnosis of plague nearly a month after his onset of symptoms. He was diagnosed with septicemic plague that presents with abdominal pain, extreme weakness, chills and fever. In severe cases it can also cause bleeding into the skin and other organs.

The report further concluded that rapid reporting may have led to a timelier diagnosis of his acute illness with a prompter initiation of effective antibiotic therapy.

Source: CDC

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.


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