Anthrax chest radiograph

Anthrax. A nonspecific prodrome (i.e., fever, dyspnea, cough, and chest discomfort) follows inhalation of infectious spores. Approximately 2-4 days after initial symptoms, sometimes after a brief period of improvement, respiratory failure and hemodynamic collapse ensue. Inhalational anthrax also might include thoracic edema and a widened mediastinum on chest radiograph. Gram-positive bacilli can grow on blood culture, usually 2-3 days after onset of illness. Cutaneous anthrax follows deposition of the organism onto the skin, occurring particularly on exposed areas of the hands, arms, or face. An area of local... 

Figure 21.2 Chest radiograph showing widened mediastinum due to inhalation anthrax. CDC/Dr. P. S. Brachman...

Inhalational anthrax Cough, chest pain, dyspnea, viral URI symptoms (sore throat, myalgias, mild fever) during prodrome Lymphadenopathy, widened mediastinum on chest radiograph, pleural effusions. Signs/symptoms progress to respiratory failure, sepsis, and hemodynamic collapse in preterminal stages. 

Chest radiograph findings can help differentiate nonanthrax ILI from inhalational anthrax. In the October 2001 outbreak, all ten inhalational anthrax patients presented with abnormal chest radiographs. The radiographic findings were easier to discern with posteroanterior and lateral views, compared to portable anteroposterior views. In comparison, most cases of ILI are not associated with radiographic... 

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