Prognosis

Plague

Plague has a high case fatality rate but is treatable with antibiotic therapy and supportive care. Before the advent of antibiotics, fatality rates were between 66% and 93% for all clinical forms. The fatality rate of bubonic plague is 66% if left untreated; however, this decreases to 13% with antibiotic treatment. Untreated pneumonic plague is almost always fatal. Septicaemic plague is frequently associated with delays in diagnosis and has a higher fatality rate than primary bubonic plague.[2]

A review of 50 cases treated in the US described zero mortality despite an average of 4 days of symptoms before initiating treatment.[27]

Fever, almost universal at presentation, resolves 2 to 4 days after initiating antibiotics.[27] Most patients leave hospital within 7 days.

Yersiniosis

In a review of 458 cases of Yersinia enterocolitica infections, only 2 deaths were attributed to Y enterocolitica.[51] A review of 53 patients treated for Y enterocolitica septicaemia demonstrated a mortality of 7.5%.[47]

Reactive arthritis presents 1 to 3 weeks after infection and usually affects joints in the lower limbs. It is more common in patients who are human leukocyte antigen-B27-positive. In one study, ongoing low back pain affected one third of patients followed for an average of 10 years after acute yersinia infection-associated arthritis.[52]

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