Is It the Black Plague? Why Your Glands Swell & Medically Approved Next Steps

If you've noticed swollen glands—especially in your neck, armpits, or groin—it's natural to worry. Some people even wonder: Is this the black plague?

The short answer: Almost certainly not.

Swollen glands are common and usually caused by everyday infections. Still, it's important to understand what's happening in your body, when to seek care, and how rare (but serious) conditions like the black plague actually present.

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What Does "Swollen Glands" Really Mean?

When people say "swollen glands," they're usually talking about swollen lymph nodes.

Lymph nodes are small, bean-shaped structures that are part of your immune system. They:

• Filter harmful germs
• Store infection-fighting white blood cells
• Help your body respond to illness

You have hundreds of lymph nodes throughout your body, but you can usually feel them in:

• The neck
• Under the jaw
• The armpits
• The groin

When they swell, it typically means your immune system is working hard to fight something off.

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What Is the Black Plague?

The black plague, also called bubonic plague, is a serious infection caused by the bacterium Yersinia pestis. Historically, it caused devastating pandemics in the 1300s, killing millions.

Today, however:

• The black plague is rare
• It is treatable with antibiotics
• Cases in the United States are uncommon and usually occur in specific rural regions
• Modern medicine dramatically reduces the risk of death when treated early

The black plague is typically spread by:

• Flea bites (often from infected rodents)
• Handling infected animals
• Rarely, person-to-person spread (in pneumonic plague)

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What Are the Symptoms of the Black Plague?

The most common form is bubonic plague. Its classic symptom is a painful, swollen lymph node called a bubo.

Symptoms may include:

• Sudden high fever
• Chills
• Severe weakness
• Headache
• Painful, very swollen lymph nodes (often in the groin, armpit, or neck)
• Skin near the swollen node may appear red or dark

The swelling is usually:

• Rapid in onset
• Extremely painful
• Accompanied by feeling very ill

This is not subtle. People with the black plague are typically very sick and deteriorate quickly without treatment.

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So Why Are Your Glands Swollen?

In most cases, swollen glands are caused by common infections, not the black plague.

The Most Common Causes

1. Viral infections

• Common cold
• Flu
• COVID-19
• Mononucleosis

Viral infections are the most frequent reason lymph nodes swell.

2. Bacterial infections

• Strep throat
• Ear infections
• Skin infections
• Dental infections

3. Local inflammation

• Acne
• Cuts or wounds near the area
• Insect bites

4. Immune conditions

• Lupus
• Rheumatoid arthritis

5. Less commonly: Cancer

• Lymphoma
• Leukemia
• Metastatic cancer

Cancer-related lymph nodes are usually:

• Firm
• Non-tender
• Persistent
• Gradually enlarging

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How Can You Tell the Difference?

Here's a simple comparison:

Feature	Common Infection	Black Plague
Fever	Sometimes mild	High and sudden
Pain	Mild to moderate	Severe
Overall illness	Often manageable	Severe and rapid
Risk exposure	Common	Rare (flea/rodent exposure)
Geographic pattern	Anywhere	Specific rural areas

If you're feeling generally okay and just have mild swelling during a cold, it is very unlikely to be the black plague.

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When Should You Be Concerned?

You should speak to a doctor promptly if you notice:

• A lymph node larger than 1–2 centimeters
• Severe pain in the swollen area
• High fever (over 101°F / 38.3°C)
• Night sweats
• Unexplained weight loss
• Nodes that don't improve after 2–4 weeks
• Rapid enlargement
• Redness and warmth over the node
• Trouble breathing or swallowing

If symptoms are severe or progressing quickly, seek urgent medical care.

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What Doctors Do to Evaluate Swollen Glands

A medical professional may:

• Perform a physical exam
• Ask about recent infections
• Review travel and animal exposure history
• Order blood tests
• Recommend imaging (like ultrasound or CT)
• In rare cases, perform a biopsy

If plague is suspected (again, rare), doctors begin immediate antibiotic treatment and notify public health authorities.

The good news: when treated early, plague survival rates are high.

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What You Can Do Right Now

If you have swollen glands but feel otherwise well:

• Rest
• Stay hydrated
• Monitor size and tenderness
• Use warm compresses
• Take over-the-counter pain relievers (as directed)

Most infection-related swelling improves within 1–3 weeks.

If you're concerned about your symptoms and want to understand what might be causing them, try Ubie's free AI-powered A Lump in the Neck Symptom Checker to get personalized insights and guidance on whether you should seek medical care.

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Why the Black Plague Is So Rare Today

Thanks to modern medicine:

• Antibiotics are highly effective
• Public health systems monitor cases
• Rodent control reduces spread
• Rapid diagnosis prevents outbreaks

In the United States, only a small number of cases occur each year, usually in the Southwest. Globally, cases are uncommon and treatable.

Unless you've had direct exposure to wild rodents or flea bites in an endemic area—and are experiencing sudden severe illness—the black plague is extremely unlikely.

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Don't Ignore Serious Symptoms

While most swollen glands are harmless and temporary, do not dismiss:

• Severe pain
• Rapid swelling
• High fever
• Signs of spreading infection
• Difficulty breathing
• Extreme fatigue or confusion

These can signal serious illness and require immediate medical attention.

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The Bottom Line

Swollen glands are common and usually mean your immune system is doing its job.

The black plague, while historically devastating, is now rare and treatable. Most people with swollen lymph nodes have:

• A cold
• A mild bacterial infection
• A temporary immune response

Still, it's important not to ignore persistent or severe symptoms.

If you're unsure what's happening, consider starting with Ubie's A Lump in the Neck Symptom Checker to better understand your symptoms and follow up by speaking with a healthcare professional.

Most importantly, if you suspect something serious or life-threatening, speak to a doctor immediately. Early evaluation brings peace of mind—and when necessary—early treatment can be lifesaving.

Your body often gives warning signs. Pay attention to them, but don't assume the worst.