TY - JOUR
T1 - Clinical predictors of bioterrorism-related inhalational anthrax
AU - Kyriacou, Demetrios N.
AU - Stein, Adam C.
AU - Yarnold, Paul R.
AU - Mark Courtney, D.
AU - Nelson, Regina R.
AU - Noskin, Gary A.
AU - Handler, Jonathan A.
AU - Frerichs, Ralph R.
N1 - Funding Information:
This study was funded by an Excellence in Academic Medicine grant from the State of Illinois Department of Public Aid and Northwestern Memorial Hospital. All authors had access to the data and independence for interpretation of the findings.
PY - 2004/7/31
Y1 - 2004/7/31
N2 - Limitation of a bioterrorist anthrax attack will require rapid and accurate recognition of the earliest victims. To identify clinical characteristics of inhalational anthrax, we compared 47 historical cases (including 11 cases of bioterrorism-related anthrax) with 376 controls with community-acquired pneumonia or influenza-like illness. Nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and raised haematocrit were more frequently recorded in the inhalational anthrax cases than in either the community-acquired pneumonia or influenza-like illness controls. The most accurate predictor of anthrax was mediastinal widening or pleural effusion on a chest radiograph. This finding was 100% sensitive (95% CI 84·6-100·0) for inhalational anthrax, 71·8% specific (64·8-78·1) compared with community-acquired pneumonia, and 95·6% specific (90·0- 98·5) compared with influenza-like illness. Our findings represent preliminary efforts toward identifying clinical predictors of inhalational anthrax.
AB - Limitation of a bioterrorist anthrax attack will require rapid and accurate recognition of the earliest victims. To identify clinical characteristics of inhalational anthrax, we compared 47 historical cases (including 11 cases of bioterrorism-related anthrax) with 376 controls with community-acquired pneumonia or influenza-like illness. Nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and raised haematocrit were more frequently recorded in the inhalational anthrax cases than in either the community-acquired pneumonia or influenza-like illness controls. The most accurate predictor of anthrax was mediastinal widening or pleural effusion on a chest radiograph. This finding was 100% sensitive (95% CI 84·6-100·0) for inhalational anthrax, 71·8% specific (64·8-78·1) compared with community-acquired pneumonia, and 95·6% specific (90·0- 98·5) compared with influenza-like illness. Our findings represent preliminary efforts toward identifying clinical predictors of inhalational anthrax.
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U2 - 10.1016/S0140-6736(04)16769-X
DO - 10.1016/S0140-6736(04)16769-X
M3 - Article
C2 - 15288744
AN - SCOPUS:3843095155
SN - 0140-6736
VL - 364
SP - 449
EP - 452
JO - Lancet
JF - Lancet
IS - 9432
ER -