The evaluation of bubonic plague begins with a complete history and physical examination.

Physical findings in those with bubonic plague may include:

• Lymph gland swelling
• Enlargement of the liver
• Enlargement of the spleen
• Fever

The diagnosis of bubonic plague must be confirmed through testing.

Tests that may be used to evaluate bubonic plague include:

• Complete blood count
• Urinalysis
• Lumbar puncture
• Kidney profile
• Direct immunofluorescence testing of fluid or cultures may aid in rapid diagnosis of plague
• Passive hemagglutination test, performed on acute or convalescent serum, with a 4-fold or greater increase in titer is suggestive for plague infection.
• Throat culture
• Sputum gram stain