Clinical features

The incubation period is from two to seven days, after which the disease may be manifested in a variety ways:

• ulceroglandular form:
  • this is the commonest manifestation of the disease
  • a papule forms at the site of entry of the infection
  • the papule ulcerates and the patient develops a suppurative, tender lymphadenopathy
  • if the site of inoculation is the eye then the patient develops a purulent conjunctivitis and periauricular lymphadenopathy
    
    
• pneumonic form:
  • presentation is with cough and chest pain
  • the patient develops a pneumonia
  • occasionally there is a pericarditis
    
    
• septicaemic form:
  • presentation is with an acute fever of sudden onset, headache, myalgia and shock