MERIDEN - Two doctors investigating the cause of an 18-year-old man's mystery ailment couldn't believe it when the diagnosis turned out to be the leading cause of death in the Middle Ages.

A Boy Scout, recently returned from a camping trip in Wyoming, arrived at MidState Medical Center's emergency room last month with a swollen gland and a high fever. He was put on antibiotics under the assumption he had mumps. Days later, the attending doctor called in Dr. Robert Levitz, who specializes in infectious diseases. Levitz found two positive blood bacteria cultures and a bad infection.

There was a large swelling on the left side of his neck in the lymph node and parotid gland, according to a report in the Jackson Hole Daily.

"He was still fairly sick" when he got to the hospital, Levitz said, adding that the swollen area was extremely painful to the touch.

Levitz sent the cultures to Clinical Laboratory Partners in Newington and, while he waited for the results, treated the patient for haemophilus - the cause of a range of diseases. Levitz ordered other antibiotics, and the young man gradually improved.

"We did get the history of him being in Wyoming," Levitz said. "I didn't think it was plague, but the classic symptoms were there."

The doctors at Clinical Laboratory were equally puzzled about the young man's blood disease. It could have been an exotic organism, but "we had no idea," said Dr. Jaber Aslanzadeh, director of microbiology at the lab.

The blood sample was sent through an automated identification system, which determined that the sample was pathogenic, which means it can cause disease. The lab performed a manual biochemical test that identified the biotype as Yesina pestis - or bubonic plague.

"I didn't believe it," Aslanzadeh said. "I said, 'Oh, my God, this can't be.' I have been in business for 20 years, and this is the first time I had seen it."

The laboratory does bioterrorism testing for the state Department of Health and, following protocol, they notified the department of the rare find.

"They didn't believe us, actually," Aslanzadeh said. "This is too unusual."

But the Centers for Disease Control and Prevention in Atlanta confirmed the finding.

Back at MidState, Levitz was ready to release the patient when he got the call from the laboratory.

"Wow," Levitz said. "I actually thought I should have stumbled onto that sooner. It all seems easier in retrospect."

Because the young man was on antibiotics for several days, he never developed pneumonic plague, which can spread through coughing, Levitz said. His age and otherwise good health helped stabilize his condition. Pneumonic plague led to the death of millions in the Middle Ages, Levitz said.

According to Levitz, although Wyoming has a small number of human cases, the rodents and prairie dogs in the Southwestern and Western parts of the country do carry the disease. It can spread to humans through flea bites or contact with an infected animal's skin.

The Wyoming Health Department said the teenager had spent time in Yellowstone National Park, Bridger-Teton National Forest and other sites in Teton County between July 26 and Aug. 3, the Jackson Hole Daily reported.

The young man was prescribed Cipro, an antibiotic, and has made a full recovery, the doctor said. He has not been identified because of medical privacy laws, although earlier reports said he lives in New Haven County.

Infectious diseases are a rarity in this country, and bubonic plague appears 10 to 15 times annually in the U.S., but it can be found in larger numbers in underdeveloped countries.

At MidState, the early diagnosis of mumps was enough to put the staff and doctors on alert because it is contagious. Every room in the hospital is private, but staff had to don masks and gloves when entering.

mgodin@record-journal.com

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