buboes

Buboes are swollen lymph nodes, most often in the groin, armpit, or neck, caused by infection of the lymphatic system. While the term is closely associated with bubonic plague caused by Yersinia pestis, buboes can occur with various infections such as bacterial lymphadenitis, cat-scratch disease, or tularemia. A bubo is typically tender, enlarged, and warm, and may rupture and drain.

Clinically, buboes arise after an incubation period and are usually accompanied by fever, malaise, and local pain. The affected node is firm and may be mobile at first, then become fluctuant if an abscess forms. In plague, buboes are often regional and can be part of a more widespread illness, including systemic symptoms if the infection spreads.

Diagnosis relies on clinical assessment and laboratory testing of aspirated material or tissue. Microbiology includes Gram stain, culture, and PCR for Yersinia pestis when plague is suspected, along with blood cultures and imaging to evaluate complications or alternative causes such as Bartonella or Staphylococcus aureus.

Treatment targets the underlying infection. Bubonic plague requires rapid antibiotic therapy (examples include streptomycin or gentamicin; doxycycline or ciprofloxacin as alternatives) and public health notification. Supportive care and drainage of abscessed buboes may be needed. Prevention focuses on vector control (rodents and fleas), avoiding exposure to infected animals, and prompt treatment of infections to reduce spread.