Anthrax laboratory findings: Difference between revisions
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[CBC]]''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[CBC]]''' | ||
| style="background: #DCDCDC; padding: 5px;"| [[Hemoconcentration]]<br>Possible [[ | | style="background: #DCDCDC; padding: 5px;"| [[Hemoconcentration]]<br>Possible [[thrombocytopenia]]<br>[[Leukocyte]] count commonly normal | ||
| style="background: #DCDCDC; padding: 5px;"| [[Anemia]]<br>[[Thrombocytopenia]]<br>[[Leukocytosis]] (late in disease) | | style="background: #DCDCDC; padding: 5px;"| [[Anemia]]<br>[[Thrombocytopenia]]<br>[[Leukocytosis]] (late in disease) | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Electrolyte]]<br>[[Renal]] Panel''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Electrolyte]]<br>[[Renal]] Panel''' | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Decreased [[ | | style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Decreased [[sodium]] level<br>Increased [[BUN]] | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Liver]] Enzymes<br>Serum [[Albumin]]''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Liver]] Enzymes<br>Serum [[Albumin]]''' | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[C-Reactive Protein]]''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[C-Reactive Protein]]''' | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Characterization of | | style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Characterization of inflammatory response<br>Typically low [[CRP]] in injection [[anthrax]] | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Gram stain]]<br>Cultures<br>Toxic Assays''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Gram stain]]<br>Cultures<br>Toxic Assays''' | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Cardiac]] Enzymes<br>[[BNP]]''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Cardiac]] Enzymes<br>[[BNP]]''' | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| [[Troponin]] leak caused by increased [[cardiac]] demand from [[infection]]<br>(particularly if [[atrial fibrillation]] with rapid [[ventricular]] response | | style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| [[Troponin]] leak caused by increased [[cardiac]] demand from [[infection]]<br>(particularly if [[atrial fibrillation]] with rapid [[ventricular]] response) | ||
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Revision as of 19:58, 17 July 2014
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Anthrax laboratory findings On the Web |
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Risk calculators and risk factors for Anthrax laboratory findings |
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. A normal PT/PTT at admission does not exclude coagulopathy nor DIC.
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.