Diagnosis:

• bacterial culture
  • gram (-) bipolar rod---It is very important that the organism not be mistakenly identified as a diplococcus!
    • Wayson or Wright's stains accentuate the bipolar appearance of the organism.
    • immunofluorescent antibody staining to confirm the identity of the bacteria as Y. pestis
• serology is used less commonly

Treatment:

• Aspirate buboes if they suppurate.
• antibiotics (suggested cours of 10-21 days)
  • Gentamicin or other aminoglycosides are the antibiotics of choice. (Streptomycin is commonly used in human beings.)
    • Yersinia pestis is often sensitive to penicillin and ampicillin in vitro, but is generally resistant to these antibiotics in vivo.
  • Doxycycline and chloramphenicol may also be useful, and fluoroquinolones are used in cases of meningitis in human beings.
• From a public health perspective, flea control is very important to prevent further spread of the organism.

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