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{{Anthrax}}
{{Anthrax}}
{{CMG}}
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==Overview==
 
==Chest X Ray==
==Chest X Ray==


The classic appearance of (inhalation) anthrax on a chest x-ray is mediastinal widening with clear lungs. Also in some patients, (hemorrhagic) pleural effusion is also present.
===Inhalational Anthrax===
 
* The earliest detectable specific finding indicative of inhalational anthrax is [[mediastinal widening]] on posteroanterior chest X-rays. However, mediastinal widening is not a rare finding 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.


[[Image:Chest anthrax.jpg|thumb|left|305px|This chest x ray image is of a patient with Anthrax]]
* Ultimately, the 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 illness are manifest. During the acute phase illness, damage of the lung tissue becomes apparent on 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 illness and primary pulmonary infection is an uncommon presentation.
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* 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>
 
==Gallery==
 
<gallery>
Image: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. <SMALL><SMALL>''[http://phil.cdc.gov/phil/  Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>
 
Image: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. <SMALL><SMALL>''[http://phil.cdc.gov/phil/  Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>
 
Image:Anthrax CXR03.jpg|PA chest radiograph of anthrax, 13th day of illness. <SMALL><SMALL>''[http://phil.cdc.gov/phil/  Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>
 
 
Image:Anthrax CXR04.jpg|PA chest radiograph of anthrax, 4th day of illness. <SMALL><SMALL>''[http://phil.cdc.gov/phil/  Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>
 
Image:Anthrax CXR05.jpg|This anteroposterior (AP) chest radiograph showed a widened mediastinum due to inhalation anthrax, and was taken 22 hours before death. <SMALL><SMALL>''[http://phil.cdc.gov/phil/  Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>
</gallery>


==References==
==References==
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{{reflist|2}}
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Revision as of 19:17, 16 July 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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 not a rare finding 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.
  • Ultimately, the 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 illness are manifest. During the acute phase illness, damage of the lung tissue becomes apparent on 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 illness and primary pulmonary infection is an uncommon presentation.

Gallery

References

  1. Turnbull, Peter (2008). Anthrax in humans and animals. Geneva, Switzerland: World Health Organization. ISBN 9789241547536.
  2. 2.0 2.1 2.2 2.3 2.4 "Public Health Image Library (PHIL), Centers for Disease Control and Prevention".