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Differential Diagnosis

In the initial phases of plague, the illness may be clinically confused with typhus, relapsing fever, dengue, tularemia, or malaria. Radiographically, the pulmonary changes are nonspecific, but the very rapid progression to involve an entire lobe or, more commonly, multiple lobes is characteristic of plague, unlike most other lung infections. Differentiation of plague pneumonia from DIC or shock lung may be difficult in patients with rapidly worsening disease.

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