Anthrax other diagnostic studies: Difference between revisions

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==Overview==
==Overview==
Important studies for the [[diagnosis]] and monitoring of [[anthrax]] patients include the [[PCR]] test for the confirmation of the [[virulence]] of the organism; [[lumbar puncture]], when not [[contraindicated]] for search of the organism in the [[CSF]], helping to exclude other [[diagnoses]]; [[EKG]] and [[echocardiogram]] to evaluate possible complications such as the [[atrial fibrillation]] and rule out [[pericardial effusion]]; along with other imaging studies to evaluate [[necrosis]] and/or [[inflammation]].
Several studies are used for the [[diagnosis]] and monitoring of anthrax.  The [[polymerase chain reaction]] ([[PCR]]) test is ordered to confirm the [[virulence]] of the organism.  In addition, [[lumbar puncture]] should be performed on admission when it is not contraindicated to search for the organism in the [[cerebrospinal fluid]] ([[CSF]]) and to to exclude other alternative diagnoses.  Other diagnostic studies include an [[electrocardiogram]] and an [[echocardiogram]] to assess possible complications of anthrax such as [[atrial fibrillation]] and [[pericardial effusion]].


==Diagnostic Studies==
==Diagnostic Studies==
Other studies to diagnose and monitor [[Anthrax]] [[infection]] and its potential [[complications]] include:<ref name="HendricksWright2014">{{cite journal|last1=Hendricks|first1=Katherine A.|last2=Wright|first2=Mary E.|last3=Shadomy|first3=Sean V.|last4=Bradley|first4=John S.|last5=Morrow|first5=Meredith G.|last6=Pavia|first6=Andy T.|last7=Rubinstein|first7=Ethan|last8=Holty|first8=Jon-Erik C.|last9=Messonnier|first9=Nancy E.|last10=Smith|first10=Theresa L.|last11=Pesik|first11=Nicki|last12=Treadwell|first12=Tracee A.|last13=Bower|first13=William A.|title=Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults|journal=Emerging Infectious Diseases|volume=20|issue=2|year=2014|issn=1080-6040|doi=10.3201/eid2002.130687}}</ref><ref name=WHO>{{cite web | title = Anthrax in Humans and Animals | url = http://www.who.int/csr/resources/publications/anthrax_web.pdf }}</ref>
Shown below is a table summarizing studies used to diagnose and monitor anthrax infection and its potential [[complications]].<ref name="HendricksWright2014">{{cite journal|last1=Hendricks|first1=Katherine A.|last2=Wright|first2=Mary E.|last3=Shadomy|first3=Sean V.|last4=Bradley|first4=John S.|last5=Morrow|first5=Meredith G.|last6=Pavia|first6=Andy T.|last7=Rubinstein|first7=Ethan|last8=Holty|first8=Jon-Erik C.|last9=Messonnier|first9=Nancy E.|last10=Smith|first10=Theresa L.|last11=Pesik|first11=Nicki|last12=Treadwell|first12=Tracee A.|last13=Bower|first13=William A.|title=Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults|journal=Emerging Infectious Diseases|volume=20|issue=2|year=2014|issn=1080-6040|doi=10.3201/eid2002.130687}}</ref><ref name=WHO>{{cite web | title = Anthrax in Humans and Animals | url = http://www.who.int/csr/resources/publications/anthrax_web.pdf }}</ref><ref name=CDC>{{cite web | title = Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults | url = http://wwwnc.cdc.gov/eid/article/20/2/13-0687_article }}</ref>


{| style="border: 2px solid #DCDCDC; font-size: 90%"
{| style="border: 2px solid #DCDCDC; font-size: 90%"
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! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Serial Monitoring}}
! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Serial Monitoring}}
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[PCR]]'''
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''PCR'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Confirms [[virulence]] of [[Bacillus anthracis|organism]] by search for [[virulence factor]] [[genes]]<br>[[Primers]] to the [[toxin]] [[gene]]<br>[[Primer]] for the [[enzyme]] of [[capsule]] formation [[gene]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Confirms [[virulence]] of [[Bacillus anthracis|organism]] by search for [[virulence factor]] [[genes]]<br>[[Primers]] to the [[toxin]] [[gene]]<br>[[Primer]] for the [[enzyme]] of [[capsule]] formation [[gene]]
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Lumbar puncture]]'''
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Lumbar puncture'''
| style="background: #DCDCDC; padding: 5px;"| At admission unless contraindicated
| style="background: #DCDCDC; padding: 5px;"| At admission unless contraindicated
| style="background: #DCDCDC; padding: 5px;"| [[Headache]]<br>[[Confusion]]<br>Other neurologic symptom<br>If [[meningitis]], [[meningeal signs]] will only be present at a later stage
| style="background: #DCDCDC; padding: 5px;"| [[Headache]]<br>[[Confusion]]<br>Other neurologic symptom<br>If [[meningitis]], [[meningeal signs]] will only be present at a later stage
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| style="background: #DCDCDC; padding: 5px;"| For [[headache]], [[confusion]] or other [[neurologic]] symptom<br>If [[meningitis]], [[meningeal signs]] will only be present at a later stage
| style="background: #DCDCDC; padding: 5px;"| For [[headache]], [[confusion]] or other [[neurologic]] symptom<br>If [[meningitis]], [[meningeal signs]] will only be present at a later stage
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[EKG]]'''
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''EKG'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| [[Atrial fibrillation]] with rapid [[ventricular]] response
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| [[Atrial fibrillation]] with rapid [[ventricular]] response
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Echocardiogram]]'''
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Echocardiogram'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Evaluate for [[pericardial effusion]]<br>Evaluate for [[myocardial]] dysfunction
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Evaluate for [[pericardial effusion]]<br>Evaluate for [[myocardial]] dysfunction
|-
|-
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[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Medical disasters]]
[[Category:Medical disasters]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Dermatology]]
[[Category:Pulmonology]]
[[Category:Gastroenterology]]

Latest revision as of 20:25, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Several studies are used for the diagnosis and monitoring of anthrax. The polymerase chain reaction (PCR) test is ordered to confirm the virulence of the organism. In addition, lumbar puncture should be performed on admission when it is not contraindicated to search for the organism in the cerebrospinal fluid (CSF) and to to exclude other alternative diagnoses. Other diagnostic studies include an electrocardiogram and an echocardiogram to assess possible complications of anthrax such as atrial fibrillation and pericardial effusion.

Diagnostic Studies

Shown below is a table summarizing studies used to diagnose and monitor anthrax infection and its potential complications.[1][2][3]

Laboratory findings
Test Initial Findings Serial Monitoring
PCR Confirms virulence of organism by search for virulence factor genes
Primers to the toxin gene
Primer for the enzyme of capsule formation gene
Lumbar puncture At admission unless contraindicated Headache
Confusion
Other neurologic symptom
If meningitis, meningeal signs will only be present at a later stage
Other imaging As relevant to site of exposure
Evaluate edema
Evaluate inflammation
Evaluate necrosis
For headache, confusion or other neurologic symptom
If meningitis, meningeal signs will only be present at a later stage
EKG Atrial fibrillation with rapid ventricular response
Echocardiogram Evaluate for pericardial effusion
Evaluate for myocardial dysfunction

References

  1. Hendricks, Katherine A.; Wright, Mary E.; Shadomy, Sean V.; Bradley, John S.; Morrow, Meredith G.; Pavia, Andy T.; Rubinstein, Ethan; Holty, Jon-Erik C.; Messonnier, Nancy E.; Smith, Theresa L.; Pesik, Nicki; Treadwell, Tracee A.; Bower, William A. (2014). "Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130687. ISSN 1080-6040.
  2. "Anthrax in Humans and Animals" (PDF).
  3. "Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults".