Plague

Thirty-five-year-old Mary Wells presents to an emergency department in rural Maine with chills, weakness, and swelling and tenderness in the right groin area. Her vital signs in triage are temperature, 39.2deg. C; heart rate, 118 beats per minute; respiratory rate, 24 breaths per minute; and blood pressure, 110 /70 mmHg. When taking her history, the nurse learns that Ms. Wells had been in excellent health until the preceding day, when she arrived home from an eight-day backpacking tripthrough the Sierra Nevada in California. In completing the physical assessment, the nurse notes swollen and tender inguinal lymph nodes on the right side and clusters of red spots and vesicles on the lower leg, right above the sock line, that the patient says are very itchy. Given the history and physical findings, the nurse promptly escorts Ms. Wells to a treatment room for evaluation and treatment of bubonic plague. Discusses how plague can manifest itself, its diagnosis and treatment. (Quotes from original text)