<s>[INST] context: Yersinia pestis Amongst the given options, only yersinia pestis produces stalactite growth. The girl has: - i) Signs of septicemia --> Fever, hypotension. ii) Axillary and inguinal lymphadenopathy iii) Stalactite growth These features are suggestive of septicaemic plague, which is caused by yersinia pestis. The clinical features mentioned in the question can also occur in rest of the options but the clincher is "stalactite growth", which is seen only in yersinia pestis infection. Survival in cold environment (girl lives in slamla) also ours yersinia pestis. Clinical features of plague Y. pestis infection 4, 4, `If Bubonic Pneumonic Septicaemic Uncommon Plague Plague Plague forms . Always primary . Mostly secondry . Mostly secondary . Meningitis . t14, C. type of plague due to metastatic spread due to metastatic . Pharyngitis . LP. 2-7 (hot from Bubonic plague spread from Bubonic . Endoplithalmitis . C/Ps are fever; chills . 1.P. 1-3 days . I.P. -4 2-7 clays. . Lymphadenills enlarged tender & . Highly infectious . Often presents with at multiple sites painful lympnodes; . Initially ore lobe is GI symptoms (nausea papule, pustule or ulcer affected, later it spreads vomiting. diarrhea and at the site of bite to other lobe abdominal paint along . M.C. lymphnode femoral . C/Fs are dyspnea, cough with other signs of and inguinal with sputum chest pain and tachycardia septicemia [/INST] question: A girl from shimla presented to OPD with fever,hypotension, malaise and axillary and inguinal lymphadenopathy. Culture in glucose broth shows stalactite growth. Most likely causative organism is | options: A: Yersinia pestis B: Francisella tularensis C: Brucella abous D: Coxiella burnetti | answer: A </s>