Clinical findings High fever, painful lymphadenopathy, commonly with greatly enlarged, tender nodes in the groin or axillae Vomiting and diarrhea may develop with early sepsis Later disseminated intravascular coagulation leads to hypotension, altered mental status, and renal and cardiac allure Terminally, signs of pneumonia and meningitis can appear, and y pestis multiplies intravascularly and can be seen in blood smearsClinical findings • High fever, painful lymphadenopathy, commonly with greatly enlarged, tender nodes in the groin or axillae. • Vomiting and diarrhea may develop with early sepsis. • Later, disseminated intravascular coagulation leads to hypotension, altered mental status, and renal and cardiac failure. • Terminally, signs of pneumonia and meningitis can appear, and Y pestis multiplies intravascularly and can be seen in blood smears