Clinical features that discriminate inhalational anthrax from other acute respiratory illnesses.

Authors

Kuehnert MJ, Doyle TJ, Hill HA, et al. 

Institution

Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, GA 30333, USA. mkuehnert@cdc.gov

Source

Clin Infect Dis 2003 Feb 1; 36(3) :328-36.

Abstract

Inhalational anthrax (IA) is a rapidly progressive disease that frequently results in sepsis and death, and prompt recognition is critical. To distinguish IA from other causes of acute respiratory illness, patients who had IA were compared with patients in an ambulatory clinic who had influenza-like illness (ILI) and with hospitalized patients who had community-acquired pneumonia (CAP) at the initial health care visit. Compared with patients who had ILI, patients who had IA were more likely to have tachycardia, high hematocrit, and low albumin and sodium levels and were less likely to have myalgias, headache, and nasal symptoms. Scoring systems were devised to compare IA with ILI or CAP on the basis of strength of association. For ILI, a score of > or =4 captured all 11 patients with IA and excluded 664 (96.1%) of 691 patients with ILI. Compared with patients who had CAP, patients with IA were more likely to have nausea or vomiting, tachycardia, high transaminase levels, low sodium levels, and normal white blood cell counts. For CAP, a score of > or =3 captured 9 (81.8%) of 11 patients with IA and excluded 528 (81.2%) of 650 patients with CAP. In conclusion, selected clinical features of patients with IA differ from those of patients with ILI and are more similar to those of patients with CAP.

Mesh

Acute Disease
Albumins
Anthrax
Headache
Hematocrit
Humans
Inhalation Exposure
Middle Aged
Respiratory Tract Infections
Tachycardia

Language

eng

Pub Type(s)

Journal Article

PubMed ID

12539075