Anthrax laboratory findings
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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
Laboratory abnormalities common in systemic anthrax include: 1) anemia, thrombocytopenia and leukocytosis, particularly in latter stages of the disease; 2) decreased sodium level and increased BUN; 3) elevated transaminase levels and hypoalbuminemia; 4) inflammatory pattern with a low CRP typical of injection anthrax; 5) identification of the organism, and possibly toxins, in cell cultures from blood, CSF, pleural fluid, among others; 6) and elevated troponin levels.
Laboratory Findings
The following tests are used in the diagnosis and monitoring of systemic anthrax:[1]
| Test | Initial Findings | Serial Monitoring |
|---|---|---|
| CBC | Hemoconcentration Possible Thrombocytopenia Leukocyte count commonly normal |
Anemia Thrombocytopenia Leukocytosis (late in disease) |
| Electrolyte Renal Panel |
Decreased Sodium level Increased BUN | |
| Liver Enzymes Serum Albumin |
Elevated transaminase levels Hypoalbuminemia | |
| PT PTT D-dimer Fibrinogen |
Normal PT/PTT does not exclude DIC or coagulopathy | Low threshold for hypercoagulability workup: Haptoglobin LDH Fibrin split products ADAMTS 13 if hemolytic anemia |
| C-Reactive Protein | Characterization of Inflammatory Response Typically low CRP in injection anthrax | |
| Gram stain Cultures Toxic Assays |
Blood Serum CSF Pleural fluid Ascites Wound exudate Bronchial exudate |
Cultures usually negative after antibiotics Toxins may be detected |
| Cardiac Enzymes BNP |
Troponin leak caused by increased cardiac demand from infection (particularly if atrial fibrillation with rapid ventricular response | |
References
- ↑ 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.