{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:19:09Z","timestamp":1790410749990,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Plague in humans and animals is caused by\n                      <jats:italic toggle=\"yes\">Yersinia pestis<\/jats:italic>\n                      , a zoonotic gram-negative bacterium endemic in certain regions of Asia, Africa, and the United States. Coinfection with both\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      and Streptococci species has been anecdotally reported in humans and associated with severe and rapidly fatal disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This report presents two cases of patients who died following\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Streptococcus<\/jats:italic>\n                      coinfection. Additional cases of previously published\n                      <jats:italic toggle=\"yes\">Y. pestis\u2013Streptococcus<\/jats:italic>\n                      coinfection were identified and reviewed using a search of electronic databases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The first case patient developed cough and dyspnea following 4 days of fever, malaise, and back pain and died before receiving medical care. Postmortem blood cultures were positive for\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Streptococcus pyogenes<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">Streptococcus dysgalactiae<\/jats:italic>\n                      . The second case patient was hospitalized with fever, vomiting, diarrhea, and dyspnea and died of sepsis and respiratory failure on the day of admission.\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                      were isolated from blood cultures drawn on admission. Seven additional cases of\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Streptococcus<\/jats:italic>\n                      coinfection were identified, dating between 1948 and 2009. These patients were healthy overall before their illness, with ages ranging from 9 to 60 years. The majority of patients had primary bubonic plague with associated pneumonia or septicemia. None of the patients who died received timely antimicrobial therapy directed against gram-negative pathogens. In every case but one, an occupational or environmental risk factor for plague was later identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      infection begins with a pre-inflammatory phase, during which\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      and other pathogens can rapidly proliferate. Streptococci, which are frequently asymptomatic colonizers, may become invasive in this environment, leading to coinfection. The challenges of diagnosing\n                      <jats:italic toggle=\"yes\">Y. pestis<\/jats:italic>\n                      in the context of coinfection may delay effective treatment. This case series and literature review illustrate the importance of clinicians remaining alert to environmental and occupational exposures in patients presenting with an infectious syndrome, especially in those who have an unexpectedly severe clinical presentation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/vbz.2022.0084","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T15:38:44Z","timestamp":1687534724000},"page":"371-377","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Perilous Combination:\n                    <i>Streptococcus<\/i>\n                    Coinfection with Human Plague\u2014Report of Two Cases and Review of the Literature, 1937\u20132022"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1860-7092","authenticated-orcid":false,"given":"Brian","family":"Erly","sequence":"first","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5607-6819","authenticated-orcid":false,"given":"Shannon","family":"Fleck-Derderian","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine M.","family":"Cooley","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Meyer-Lee","sequence":"additional","affiliation":[{"name":"Larimer County Department of Health and Environment, Fort Collins, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"House","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment, Denver, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"VinHatton","sequence":"additional","affiliation":[{"name":"New Mexico Department of Health, Santa Fe, New Mexico, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.02645-15"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-018-0656-y"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00044-19"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph110201824"},{"issue":"27","key":"e_1_3_5_6_1","first-page":"617","article-title":"Fatal human plague\u2014Arizona and Colorado, 1996","volume":"46","author":"Centers for Disease Control and Prevention (CDC)","year":"1997","unstructured":"Centers for Disease Control and Prevention (CDC). Fatal human plague\u2014Arizona and Colorado, 1996. MMWR Morb Mortal Wkly Rep, 1997; 46(27):617\u2013620.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"7","key":"e_1_3_5_7_1","first-page":"201","article-title":"Fatal laboratory-acquired infection with an attenuated Yersinia pestis strain\u2014Chicago, Illinois, 2009","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","unstructured":"Centers for Disease Control and Prevention (CDC). Fatal laboratory-acquired infection with an attenuated Yersinia pestis strain\u2014Chicago, Illinois, 2009. MMWR Morb Mortal Wkly Rep, 2011; 60(7):201\u2013205.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_5_8_1","unstructured":"Centers for Disease Control and Prevention (CDC). Active Bacterial Core Surveillance Report Emerging Infections Program Network Group A Streptococcus; 2019. 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Chin Med J, 1949; 67:547\u2013550.","journal-title":"Chin Med J"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.13.1493"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13059-021-02580-z"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1948.s1-28.361"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS10786J"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2101.140564"},{"key":"e_1_3_5_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00518"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/iai.00559-09"},{"issue":"1","key":"e_1_3_5_21_1","first-page":"54","article-title":"Plague in the United States, 1995\u20131997","volume":"16","author":"Levy CE","year":"1999","unstructured":"Levy CE, , Gage KL. Plague in the United States, 1995\u20131997. 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