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Am. J. Trop. Med. Hyg., 78(6), 2008, pp. 868-871
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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CASE REPORT


Septicemic Plague in a Community Hospital in California

David A. Margolis, Joseph Burns, Sharon L. Reed, Michele M. Ginsberg, Terrence C. O’Grady, AND Joseph M. Vinetz*
Divisions of Infectious Diseases and Dermatology, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California; California Department of Public Health, Vector-Borne Disease Section, Ontario, California; San Diego Health Department, San Diego, California

 

ABSTRACT

Diagnosis of a case of septicemic plague acquired in rural California was delayed because of a series of confounding events, resulting in concern about reliance on community hospitals as sentinels for detecting potential bioterrorism-related events. An epizootic study confirmed the peridomestic source of Yersinia pestis infection.

Received March 11, 2008. Accepted for publication March 17, 2008.

Acknowledgments: The authors thank Peter Fedullo and members of the UCSD Medical Center pulmonary and critical care team, Ravindra Mehta and Mita Shah, of the Division of Nephrology, William Read, Thomas Kipps, Dan Tong, and the UCSD Medical Center Department of Medicine housestaff, clinical fellows, and hospital staff for excellent contributions to the care of this patient; Chris Peter and the San Diego County Public Health Services for prompt diagnostic testing; Charles Smith, Curtis Fritz, Jim Tucker, and Tina Feiszli for field and technical support; the California Department of Public Health Microbial Diseases Laboratory for diagnostic animal and arthropod testing, and Bruno Chomel of the UC Davis School of Veterinary Medicine for Nobuto testing.

* Address correspondence to Joseph M. Vinetz, Division of Infectious Diseases, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive, 0741, George Palade Laboratories, Room 125, La Jolla, CA 92093. E-mail: jvinetz{at}ucsd.edu

Authors’ addresses: David Margolis, Sharon Reed, Terrence O’Grady, and Joseph Vinetz, Divisions of Infectious Diseases and Dermatology, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California. Joseph Burns, California Department of Public Health, Vector-Borne Disease Section, Ontario, California. Michele Ginsberg, San Diego Health Department, San Diego, California






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.