Plague in a Pediatric Patient: Case Report and Use of Polymerase Chain Reaction as a Diagnostic Aid

Wendi K Drummond; Christina A Nelson; Joe Fowler; Erin E Epson; Paul S Mead; Elisabeth W Lawaczeck

doi:10.1093/jpids/piu001

Plague in a Pediatric Patient: Case Report and Use of Polymerase Chain Reaction as a Diagnostic Aid

J Pediatric Infect Dis Soc. 2014 Dec;3(4):e38-41. doi: 10.1093/jpids/piu001. Epub 2014 Mar 12.

Authors

Wendi K Drummond¹, Christina A Nelson², Joe Fowler³, Erin E Epson⁴, Paul S Mead², Elisabeth W Lawaczeck⁵

Affiliations

¹ Rocky Mountain Hospital for Children at Presbyterian St. Luke's Medical Center, Denver, Colorado.
² Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Ft. Collins, Colorado.
³ San Juan Basin Health Department, Durango, Colorado.
⁴ Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Colorado Department of Public Health and Environment, Denver.
⁵ Colorado Department of Public Health and Environment, Denver.

PMID: 26625461
DOI: 10.1093/jpids/piu001

Abstract

We report a case of bubonic plaque in a 7-year-old patient who presented with a core temperature of 107°F, seizures, vomiting, altered mental status, and septic shock. This case highlights the utility of polymerase chain reaction (PCR) as a diagnostic aid for rapid presumptive identification of Yersinia pestis as well as the importance of correlating PCR results with clinical data. We discuss the various manifestations of plague as they relate to infection control, postexposure prophylaxis, antimicrobial therapy, and treatment duration.

Keywords: Yersinia pestis.; bubonic plague; infection control; pediatric; polymerase chain reaction.