Symptoms from plague exposure usually develop within 2-6 days following the exposure. Pneumonic plague occurs a little faster, from 1 to 3 days, which is also dependent on the amount of organisms inhaled. Symptoms of bubonic plague include enlarged lymph nodes, fever, chills, and prostration. Pneumonic plague symptoms are similar to bubonic and include high fever and chills, which are accompanied by cough and difficulty breathing, production of a bloody sputum, and toxemia. Symptoms may be followed by rapid shock and death if treatment is not begun early. Death results from respiratory failure, circulatory collapse, and a predisposition toward bleeding. Bubonic plague can progress spontaneously to septicemic plague accompanied by fever, chills, prostration, abdominal pain, shock and other organs. It can also affect the central nervous system, lungs, and other parts of the body. As many as 80% of bubonic plague victims have positive blood cultures for septicemia. Approximately 25% of the patients will also have various types of skin lesions. Pustules, vesicles, eschars (dead tissue separating from living tissue), or papules (small elevation of the skin) containing leukocytes and bacteria may also be present near the site of the fleabite.