Anthrax Case Shows That Symptoms Differ From Flu
dailynews.yahoo.com
By Merritt McKinney
Thursday November 8 5:29 PM ET
NEW YORK (Reuters Health) - With the aim of helping physicians recognize the signs of inhalational anthrax, doctors who treated the Florida man who died of the disease in early October have released a report on his illness.
The report may also help calm the nerves of the public as the flu and cold season begins, according to its lead author.
None of the recent cases of inhalational anthrax have caused symptoms that are common in the fall and winter such as runny nose, sore throat and congestion, Dr. Larry M. Bush of Atlantis Medical Center in Fort Lauderdale, Florida, told Reuters Health.
In a report in the November 29th issue of The New England Journal of Medicine (news - web sites), Bush and colleagues describe the case of Robert Stevens, 63, who developed the first case of inhalational anthrax in the US since 1978. He was a photo editor at American Media Inc., a tabloid newspaper publisher that was later found to have received an anthrax-laced letter at its office.
On October 2nd, the patient and his wife went to the hospital after he woke up with fever, vomiting and confusion. For the preceding 4 days, the man had experienced fever, muscle pain and general malaise--a vague feeling of bodily discomfort. However, he had no upper respiratory symptoms, such as a runny nose or sore throat.
Doctors suspected that Stevens might have had bacterial meningitis, so they gave him two antibiotics used to treat the illness.
Bush and his colleagues first suspected inhalational anthrax when they reviewed the results of several tests taken when the man was admitted to the hospital.
A chest x-ray showed that the man had a widened mediastinum, the space in the chest behind the sternum (breastbone) between the lungs, which is a tell-tale sign of inhalational anthrax. Testing of the man's spinal fluid showed that it was cloudy and contained many large bacteria that could have been anthrax.
At this time, the doctors began treating the patient with high doses of a type of penicillin that is used to treat anthrax infection.
The man's condition began to deteriorate rapidly, however, and he started having seizures and eventually developed respiratory failure. On the third day in the hospital, the patient died.
This case ``highlights the importance of physicians' ability to recognize potential cases in the identification and treatment of diseases associated with biologic terrorism,'' Bush and his colleagues conclude.
Since symptoms of inhalational anthrax are often likened to the flu, some people may fear that they have come down with anthrax the next time they feel a little bit under the weather.
But, the physician explained, many symptoms of the cold, flu and other common illnesses do not occur in cases of inhalational anthrax.
``All the cases so far did not present with upper respiratory tract infection,'' he said. According to Bush, anthrax does not cause many common respiratory symptoms such as runny nose and sinus congestion. He also noted that none of the patients with inhalational anthrax have developed pneumonia.
The flu-like symptoms caused by inhalational anthrax, he indicated, include high fever and achy muscles.
As a word of reassurance, Bush pointed out that, with one exception, all exposures to anthrax have occurred in people who worked in newsrooms, government offices, mailrooms and news agencies.
The one exception was Kathy Nguyen, a 61-year-old employee at a New York hospital who died of inhalational anthrax. Investigators are still trying to determine how she was exposed to the bacteria.
Unless additional cases begin appearing in the general public, it is unlikely that a person's symptoms are caused by anthrax, Bush stressed.
But if people have concerns about any symptoms they develop, they should contact a physician, Bush said. He pointed out that practicing physicians ``are the ones who are on the front-line'' for recognizing cases of anthrax.
SOURCE: The New England Journal of Medicine 2001;345. |
