Tachypnea and dyspnea are also common. Thin, watery, blood-tinged sputum becomes frankly bloody and mucopurulent as the disease rapidly progresses. Plague bacillus can be cultured from sputum, and disease transmission is thought to occur up to 2 meters from a coughing patient. Generally, patients with any form of plague are toxic in appearance. Apprehension and tachycardia are also common.
All patients are febrile with chills.
A large bubo is palpable in the groin, axilla, or neck of patients with bubonic plague. The mass is fixed, edematous, exquisitely tender, and often surrounded by an area of erythema. Intra-abdominal buboes may be accompanied by tenderness, guarding, and other peritoneal signs. Hepatomegaly can be present. Septicemic patients present with tachycardia, tachypnea, and hypotension.