Bubonic Plague Symptoms: The Classic Presentation of the Black Death

The bubonic plague (caused by Yersinia pestis) is the most common form. Incubation: 2–7 days. Untreated mortality: 30–60%.

Hallmark Signs

• Buboes: Painful, swollen lymph nodes (groin, axilla, neck) — suppurate, may rupture. "Bubo" = Greek for groin swelling.
• Sudden high fever: 38.5–40.5°C (101–105°F).
• Prostration: Extreme fatigue, malaise.

Systemic Symptoms

• Severe headache
• Chills, rigors
• Myalgia, arthralgia
• Nausea, vomiting
• Tachycardia, hypotension (septic shock)
• DIC (disseminated intravascular coagulation) → purpura, necrosis → blackened skin (name "Black Death")

Other Forms

• Septicemic: Bacteremia without buboes → rapid shock, DIC, high mortality.
• Pneumonic: Lung infection → cough, hemoptysis, dyspnea, person-to-person airborne spread. Nearly 100% fatal if untreated.

Modern Treatment

• Streptomycin, gentamicin, doxycycline, ciprofloxacin, chloramphenicol.
• Early antibiotics drop mortality to <10%.
• Post-exposure prophylaxis for contacts.

Current Status

Endemic in rodent reservoirs (SW US, Africa, Asia, South America). ~1000–2000 cases/year globally. Rare but not extinct.