Anthrax diagnosis

Suggested Alternatives for Differential Diagnosis Other causes of pneumonia, typhoid fever, tuberculosis, plague, anthrax infection, smallpox. 

Suggested Alternatives for Differential Diagnosis Colics, anthrax, equine rhinopneumonitis, equine infectious anemia, equine influenza, equine encephalosis, equine viral arteritis, and piroplasmosis. Field diagnosis may be virtually impossible. 

Suggested Alternatives for Differential Diagnosis Acute respiratory distress syndrome, congestive heart failure, pulmonary edema, AIDS, pneumonia, cardiogenic shock, septic shock, phosgene toxicity, phosphine toxicity, salicylate toxicity with pulmonary edema, influenza, plague, tularemia, and anthrax. 

Suggested Alternatives for Differential Diagnosis African horse sickness, anthrax, botulism, pasteurellosis, equine influenza, peracute equine herpesvirus 1 infection, and ingestion of plant or agricultural poisons. 

Suggested Alternatives for Differential Diagnosis Anthrax, brucellosis, dengue, ehrlichiosis, infectious mononucleosis, Kawasaki disease, leptospirosis, malaria, meningitis, men-ingococcemia, relapsing fever, Rocky Mountain spotted fever, syphilis, toxic shock syndrome, toxoplasmosis, tularemia, typhoid fever, rubella, measles. 

Suggested Alternatives for Differential Diagnosis Anthrax, tetanus, rabies, meningitis, encephalitis, cerebral trypanosomiasis, piroplasmosis, theileriosis, listeriosis, parasitism poisoning by strychnine, lead, organophosphates, arsenic, and various plants that affect the central nervous system. 

Differential Diagnosis An epidemic of inhalation anthrax in its early stage with nonspecific symptoms could be confused with a number of viral, bacteria, and fungal infections. Progression over two to three days with sudden development of severe respiratory distress followed by shock and death within twenty-four to thirty-six hours in essentially all untreated cases eliminates diagnosis other than inhalation anthrax. Other diagnosis to consider would include aerosol exposure to staphylococcal enterotoxin B (SEB), plague, or tularemia pneumonia. 

Each state varies considerably as to which diseases must be reported, to whom the information is reported, who is required to report, and what information they are required to provide concerning the patient. For example, whereas almost all states require reporting of new cases of anthrax, either within 24 hours or sometimes beyond 24 hours of diagnosis, less than half of the states require any reporting of new cases of smallpox (Horton, Misrahi, Matthews, Kocher, 2002). (For a summary of the different state laws on the reporting of diseases that might possibly be associated with a bioterrorist attack, see Horton et ah, 2002). 

The diagnosis of cutaneous anthrax, likewise, is initially difficult. A history of skin contact with anthrax spores or potentially anthrax-contaminated animal products is helpful. In early stages, the skin lesion is very nonspecific, hut the later presence of a painless black eschar accompanied hy severe localized edema is essentially pathognomonic for the diagnosis. Other causes of painful lymphadenopathy such as staph, strep, plague, and tularemia may mimic cutaneous anthrax. Cutaneous anthrax lesions can also resemble the necrotic ulcerated lesions due to brown recluse spider bite. 

Bell, D. M., Kozarsky, P. E., Stephens, D. S. (2002). Clinical issues in the prophylaxis, diagnosis, and treatment of anthrax. Emerging Infectious Diseases, 8, 222-225. 

Localized Cutaneous Lesion Specific diagnosis consistent with cutaneous anthrax or tularemia Acute localized edema or lesion that may be consistent with cutaneous anthrax or tularemia Anthrax (cutaneous) Tularemia... 

Gastrointestinal Acute infection of the upper and or lower gastrointestinal (Gl) tract Specific diagnosis of Gl distress such as Salmonella gastroenteritis Acute nonspecific symptoms of Gl distress such as nausea, vomiting, or diarrhea Anthrax (gastrointestinal)... 

Respiratory Acute infection of the upper and /or lower respiratory tract Specific diagnosis of acute respiratory tract infection (RTI) Acute nonspecific diagnosis of RTI Acute nonspecific symptoms of RTI such as cough, shorfness of breafh Anthrax (inhaiationai) Tularemia Plague (pneumonic)... 

Friedlander, A.M. (1999). Clinical aspects, diagnosis and treatment of anthrax. J. Appl. Microbiol. 87 303. 

Shafazand, S., Doyle, R., Ruoss, S., Weinacker, A., Raffin, T.A. (1999). Inhalational anthrax epidemiology, diagnosis, and management. Chest 116 1369-76. 

Prompt clinical diagnosis and treatment with effective antimicrobial drugs is necessary for successful treatment of anthrax. Although B. anthracis is susceptible to penicillin in vitro it is not used as monotherapy. Several historical strains produce an inducible p-lac-tamase and are resistant to penicillin. Ciprofloxacin (400 mg intravenously twice daily) and possibly other quinolones or doxycycline (200 mg intravenously... 

Once the attack and the agent have been identified through clinical diagnosis, public health officials will provide information about the symptoms and instruct you to get medical treatment immediately if you display any of them. Anthrax can be prevented or cured with aggressive use of antibiotics. Although smallpox has no cure, medical care increases the chances of survival. 

The mortality rate of occupationally acquired inhalational anthrax cases in the United States had been 89%, but most of these cases occurred before the development of critical care units, and in some cases, before the advent of antibiotics. In the October 2001 attacks, five of 11 patients with inhalational anthrax died. This recent experience suggests that early diagnosis and treatment is critical to improving survival. 

Early Diagnosis of Inhalational Anthrax Differentiating Anthrax from Influenza-like Illness... 

---