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===Inhalational Anthrax=== | ===Inhalational Anthrax=== | ||
* The earliest detectable specific finding indicative of inhalational anthrax is [[mediastinal widening]] on posteroanterior chest X-rays. However, mediastinal widening is | * The earliest detectable specific finding indicative of inhalational anthrax is [[mediastinal widening]] on posteroanterior chest X-rays. However, mediastinal widening is common in a series of patients presenting at a emergency department | ||
* Lymphatic stasis resulting from the damaged lymph nodes leads to dilatation of pulmonary [[lymphatics]] which originate in the pleura and drain towards the hilum, following interlobular septa in association with blood vessels. The lymphatic stasis manifests as an early onset [[pleural effusion]] and peripheral infiltrates, representing thickened bronchovascular bundles, detectable on chest X-ray. These findings mark fully developed initial stage illness. | * Lymphatic stasis resulting from the damaged [[lymph nodes]] leads to dilatation of [[pulmonary]] [[lymphatics]] which originate in the [[pleura]] and drain towards the [[hilum]], following interlobular septa in association with [[blood vessels]]. The [[lymphatic]] stasis manifests as an early onset [[pleural effusion]] and peripheral infiltrates, representing thickened bronchovascular bundles, detectable on chest X-ray. These findings mark fully developed initial stage illness. | ||
* | * Bacteria escape from the damaged [[lymph node]]s and invade the [[blood stream]] via the [[thoracic duct]]. Once the [[bacteremia]] and associated [[toxemia]] reach a critical level, the severe [[symptoms]] characteristic of the acute phase of illness are manifested. During the acute phase, damage of the [[lung]] tissue becomes apparent on the [[X-ray]]. This damage results from the action of [[anthrax toxin]] on the [[endothelium]] of the lung’s [[capillary bed]]. Primary damage of the [[lung]] is not normally a feature of the initial phase of illness and primary pulmonary infection is an uncommon presentation. | ||
* The X-ray picture of the lung appears to be a very sensitive diagnostic aid with multiple abnormalities, including [[mediastinal widening]], paratracheal fullness, [[pleural effusion]]s, parenchymal infiltrates, and mediastinal [[lymphadenopathy]].<ref>{{cite book | last = Turnbull | first = Peter | title = Anthrax in humans and animals | publisher = World Health Organization | location = Geneva, Switzerland | year = 2008 | isbn = 9789241547536 }}</ref> | * The [[X-ray]] picture of the [[lung]] appears to be a very sensitive diagnostic aid with multiple abnormalities, including [[mediastinal widening]], paratracheal fullness, [[pleural effusion]]s, parenchymal infiltrates, and [[mediastinal]] [[lymphadenopathy]].<ref>{{cite book | last = Turnbull | first = Peter | title = Anthrax in humans and animals | publisher = World Health Organization | location = Geneva, Switzerland | year = 2008 | isbn = 9789241547536 }}</ref> | ||
==Image Gallery== | ==Image Gallery== | ||
Revision as of 01:33, 17 July 2014
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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
Chest X Ray
Inhalational Anthrax
- The earliest detectable specific finding indicative of inhalational anthrax is mediastinal widening on posteroanterior chest X-rays. However, mediastinal widening is common in a series of patients presenting at a emergency department
- Lymphatic stasis resulting from the damaged lymph nodes leads to dilatation of pulmonary lymphatics which originate in the pleura and drain towards the hilum, following interlobular septa in association with blood vessels. The lymphatic stasis manifests as an early onset pleural effusion and peripheral infiltrates, representing thickened bronchovascular bundles, detectable on chest X-ray. These findings mark fully developed initial stage illness.
- Bacteria escape from the damaged lymph nodes and invade the blood stream via the thoracic duct. Once the bacteremia and associated toxemia reach a critical level, the severe symptoms characteristic of the acute phase of illness are manifested. During the acute phase, damage of the lung tissue becomes apparent on the X-ray. This damage results from the action of anthrax toxin on the endothelium of the lung’s capillary bed. Primary damage of the lung is not normally a feature of the initial phase of illness and primary pulmonary infection is an uncommon presentation.
- The X-ray picture of the lung appears to be a very sensitive diagnostic aid with multiple abnormalities, including mediastinal widening, paratracheal fullness, pleural effusions, parenchymal infiltrates, and mediastinal lymphadenopathy.[1]
Image Gallery
-
![This right-lateral chest x-ray revealed evidence of a pulmonic infection 4 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/images/4/4c/Anthrax_CXR01.jpg)
This right-lateral chest x-ray revealed evidence of a pulmonic infection 4 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2] -
![This right-lateral chest x-ray revealed evidence of a pulmonic infection 13 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/images/3/39/Anthrax_CXR02.jpg)
This right-lateral chest x-ray revealed evidence of a pulmonic infection 13 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2] -
![PA chest radiograph of anthrax, 13th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/images/f/f9/Anthrax_CXR03.jpg)
PA chest radiograph of anthrax, 13th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2] -
![PA chest radiograph of anthrax, 4th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/images/2/26/Anthrax_CXR04.jpg)
PA chest radiograph of anthrax, 4th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2] -
![This anteroposterior (AP) chest radiograph showed a widened mediastinum due to inhalation anthrax, and was taken 22 hours before death. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/images/5/5b/Anthrax_CXR05.jpg)
This anteroposterior (AP) chest radiograph showed a widened mediastinum due to inhalation anthrax, and was taken 22 hours before death. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]
![This right-lateral chest x-ray revealed evidence of a pulmonic infection 4 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/index.php/File:Anthrax_CXR01.jpg)
![This right-lateral chest x-ray revealed evidence of a pulmonic infection 13 days after this patient had been exposed to the bacillus, Bacillus anthracis, the cause of the disease known as anthrax. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/index.php/File:Anthrax_CXR02.jpg)
![PA chest radiograph of anthrax, 13th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/index.php/File:Anthrax_CXR03.jpg)
![PA chest radiograph of anthrax, 4th day of illness. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/index.php/File:Anthrax_CXR04.jpg)
![This anteroposterior (AP) chest radiograph showed a widened mediastinum due to inhalation anthrax, and was taken 22 hours before death. Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.[2]](/index.php/File:Anthrax_CXR05.jpg)
References
- ↑ Turnbull, Peter (2008). Anthrax in humans and animals. Geneva, Switzerland: World Health Organization. ISBN 9789241547536.
- ↑ 2.0 2.1 2.2 2.3 2.4 "Public Health Image Library (PHIL), Centers for Disease Control and Prevention".