Clinical Issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax

Bell, David M.; Kozarsky, Phyllis E.; Stephens, David S.

doi:10.3201/eid0802.01-0521

Cited by 99 publications

(73 citation statements)

References 7 publications

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“…12 In addition to usually painless eschars, patients may also experience fever, edema, and other systemic symptoms. 12,21,22 In the 2001 anthrax attacks in the United States, there were 22 total cases, of which 11 were cases of cutaneous anthrax. 22,23 Gastrointestinal (GI) anthrax results from the ingestion of spores in vehicles such as contaminated meat.…”

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confidence: 99%

“…12,21,22 In the 2001 anthrax attacks in the United States, there were 22 total cases, of which 11 were cases of cutaneous anthrax. 22,23 Gastrointestinal (GI) anthrax results from the ingestion of spores in vehicles such as contaminated meat. GI anthrax falls into 2 categories: oropharyngeal and intestinal.…”

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confidence: 99%

“…In the 2001 US anthrax attacks, there were 11 confirmed cases of inhalation anthrax with 5 deaths and an average incubation period of 4 days. [21][22][23]29,30 Both the United States and the former Soviet Union actively investigated the use of B. anthracis as an offensive EVALUATION OF ASSAY FOR DETECTING Bacillus anthracis SPORES biological weapon; Iraq has admitted to such work as well. 27 The Federal Select Agent Program classifies B. anthracis as a Tier 1 agent due, in part, to its ease of dispersal and high mortality rate, although anthrax is not transmissible from person to person.…”

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confidence: 99%

“…3,12,14,[24][25][26] The diagnosis of inhalation anthrax presents a challenge because initial symptoms, including fever, malaise, and a dry cough, are nonspecific and resemble influenzalike symptoms, although chest X-rays typically show a widening of the mediastinum caused by hemorrhage and necrosis. 3,12,14,21,22,24 A direct Gram stain of patient tissue or fluids can be performed, and suspicious results should immediately be reported to the Centers for Disease Control and Prevention (CDC). 3 Spores, which typically measure between 1 and 2 microns in diameter, are of the ideal size to cause inhalation-associated infections.…”

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confidence: 99%

“…3,14,28 Recommended postexposure prophylaxis for inhalation anthrax is 60 days of treatment with ciprofloxacin or doxycycline, although other antibiotics, including levofloxacin, moxifloxacin, amoxicillin, or penicillin VK, may be used as well. 3,14,[22][23][24] Mechanical ventilation and other palliative care may also be necessary. In the 2001 US anthrax attacks, there were 11 confirmed cases of inhalation anthrax with 5 deaths and an average incubation period of 4 days.…”

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Comprehensive Laboratory Evaluation of a Highly Specific Lateral Flow Assay for the Presumptive Identification ofBacillus anthracisSpores in Suspicious White Powders and Environmental Samples

et al. 2016

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We conducted a comprehensive, multiphase laboratory evaluation of the Anthrax BioThreat Alert Ò test strip, a lateral flow immunoassay (LFA) for the rapid detection of Bacillus anthracis spores. The study, conducted at 2 sites, evaluated this assay for the detection of spores from the Ames and Sterne strains of B. anthracis, as well as those from an additional 22 strains. Phylogenetic near neighbors, environmental background organisms, white powders, and environmental samples were also tested. The Anthrax LFA demonstrated a limit of detection of about 10 6 spores/mL (ca. 1.5 · 10 5 spores/assay). In this study, overall sensitivity of the LFA was 99.3%, and the specificity was 98.6%. The results indicated that the specificity, sensitivity, limit of detection, dynamic range, and repeatability of the assay support its use in the field for the purpose of qualitatively evaluating suspicious white powders and environmental samples for the presumptive presence of B. anthracis spores.

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Comprehensive Laboratory Evaluation of a Highly Specific Lateral Flow Assay for the Presumptive Identification ofBacillus anthracisSpores in Suspicious White Powders and Environmental Samples

et al. 2016

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Neurologic Complications of Anthrax

Meyer

2003

Arch Neurol

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A review of the literature suggests that the major neurologic symptom complex of infection by Bacillus anthracis is a fulminant and rapidly fatal hemorrhagic meningoencephalitis and that the reported initial mode of entry can be via the cutaneous or inhalation route. For febrile patients with acute neurologic deterioration with associated findings of dark necrotic pustules on the extremities, gram-positive rods in the cerebrospinal fluid, and multifocal areas of unexplained intracerebral hemorrhage on computed tomographic scans, anthrax should be considered within the differential diagnosis. A low cerebrospinal fluid glucose level has been reported, with gram-positive rods often noted on the gram stain of the cerebrospinal fluid in severely affected patients. Reports indicate that death usually occurs within a week.

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