Radiographic manifestations of plaque in New Mexico, 1975-1980. A review of 42 proved cases.

Abstract

The radiographic findings in 42 proved cases of plague are examined. There was a high association between bilateral alveolar infiltrates and secondary pneumonic plague; however, these findings were not completely specific, as they were also seen in some patients who had disseminated intravascular coagulation or shock lung, In an endemic area and in the proper clinical setting, any patient with bilateral alveolar infiltrates should be considered to have secondary pneumonic plague until proved otherwise.

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“…39 Blood analysis may be very informative. Most patients have hyperleucocytosis, and 50% have a white blood cell count over 20,000/mm 3 .…”

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“…The disease progresses rapidly, however, and chest radiographs described for nine cases of secondary plague pneumonia showed alveolar infiltrates in all cases and pleural effusions in more than half of patients (Alsofrom et al, 1981). The disease progresses rapidly, however, and chest radiographs described for nine cases of secondary plague pneumonia showed alveolar infiltrates in all cases and pleural effusions in more than half of patients (Alsofrom et al, 1981).…”

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“…There are no pathognomonic radiographic characteristics of primary pneumonic plague. In primary infections radiographic signs usually begin as localized unilateral alveolar infiltrates that quickly advance to patchy, diffuse, and bilateral pneumonitis; in secondary pneumonic cases infiltrates are mostly bilateral, involving lower lung fields [121]. Early presumptive diagnosis can be made by Gram, Wright-Giemsa, or direct fluorescent antibody (DFA) staining of peripheral blood, sputum, or lymph node aspirates that will reveal a bipolar ''safety pin'' morphology that distinguishes plague bacilli from other gram-negative organisms.…”