Anthrax laboratory findings: Difference between revisions
Rim Halaby (talk | contribs) |
Rim Halaby (talk | contribs) |
||
| Line 12: | Line 12: | ||
|+ '''Laboratory findings''' | |+ '''Laboratory findings''' | ||
|- | |- | ||
! style="width: | ! style="width: 150px; background: #4479BA; text-align: center;"|{{fontcolor|#FFF|Test}} | ||
! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Initial Findings}} | ! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Initial Findings}} | ||
! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Serial Monitoring}} | ! style="width: 200px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Serial Monitoring}} | ||
| Line 33: | Line 33: | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Characterization of inflammatory response<br>Typically low [[CRP]] in injection [[anthrax]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Characterization of inflammatory response<br>Typically low [[CRP]] in injection [[anthrax]] | ||
|- | |- | ||
| 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'''<br>([[Blood]], [[serum]], [[CSF]], [[pleural fluid]], [[ascites]], wound [[exudate]], bronchial [[exudate]]) | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" colspan=2| Cultures usually negative after [[antibiotics]]<br>[[Toxins]] may be detected | |||
| style="background: #DCDCDC; padding: 5px;"| Cultures usually negative after [[antibiotics]]<br>[[Toxins]] may be detected | |||
|- | |- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Cardiac]] Enzymes<br>[[BNP]]''' | | style="background: #F5F5F5; padding: 5px; text-align: center;"| '''[[Cardiac]] Enzymes<br>[[BNP]]''' | ||
Revision as of 20:09, 17 July 2014
|
Anthrax Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Anthrax laboratory findings On the Web |
|
American Roentgen Ray Society Images of Anthrax laboratory findings |
|
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
When systemic anthrax is present, abnormalities in laboratory tests include anemia, thrombocytopenia, and leukocytosis particularly in latter stages of the disease. Other laboratory findings are hyponatremia, increased BUN, elevated transaminase levels, hypoalbuminemia, and elevated troponin. Cell cultures from blood, CSF, or pleural fluid can identify the organism and possibly the toxins. In injection anthrax, the typical labortatory finding is an inflammatory pattern with a low CRP. 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.