bubonic plague /byo̅o̅bon″ik/ [Gk, boubon, groin; L, plaga, stroke] , the most common form of plague. The symptoms are caused by an endotoxin released by a bacillus, Yersinia pestis, usually introduced into the body by the bite of a rat flea that has bitten an infected rat. Inoculation with plague vaccine confers partial immunity; infection provides lifetime immunity. Also called black death, black plague. Compare pneumonic plague, septicemic plague. See also bubo, plague, Yersinia pestis. ▪ OBSERVATIONS: It is characterized by painful buboes in the axilla, groin, or neck; fever often rising to 106° F (41.11° C); prostration with a rapid, thready pulse; hypotension; delirium; and bleeding into the skin from the superficial blood vessels. ▪ INTERVENTIONS: Treatment includes antibiotics, supportive nursing care, surgical drainage of buboes, isolation, and stringent precautions against spread of the disease. ▪ PATIENT CARE CONSIDERATIONS: Conditions favor a plague epidemic when a large infected rodent population lives with a large nonimmune human population in a damp, warm climate. Improved sanitary conditions and eradication of rats and other rodent reservoirs of Y. pestis may prevent outbreaks of the disease. Killing the infected rodents, which may include ground squirrels and rabbits, and not the fleas allows a continued threat of human infection. It is a possible agent of bioterrorism if the bacilli are aerosolized and has the highest potential for negative public health consequences.
