Flea bites, fever, painful and suppurative bubos in the groin.

• A. Typhoid Fever
• B. Epidemic Typhus
• C. Leptospirosis
• D. Plague (Yersinia pestis)

Answer: (D)

Flea bites with fever and painful, suppurative buboes in the groin point to bubonic plague. The hallmark feature is fever plus tender, swollen lymph nodes (buboes) that typically occur where the lymphatic drainage from the bite site concentrates—often in the groin, armpit, or neck. In plague, the lymph nodes can become inflamed, enlarging rapidly and sometimes forming an abscess that may drain purulent material. This presentation is classic for Yersinia pestis transmitted by fleas from rodent hosts.

The other options don’t fit this pattern. Typhoid fever usually presents with prolonged fever and abdominal symptoms, not localized painful groin bubo formation. Epidemic typhus features fever with a gradual onset and a rash, rather than focal, tender lymphadenopathy. Leptospirosis tends to cause fever with myalgias, conjunctival suffusion, and sometimes jaundice or renal involvement, not a draining groin bubo.

So the combination of a flea bite history, fever, and a painful, suppurative inguinal bubo is most consistent with bubonic plague.