Check out the full article: http://www.chestjournal.org/cgi/content/full/116/5/1369#T3
Diagnosis and Treatment Diagnosis of inhalational anthrax during the first stage is difficult. The symptoms and signs of disease are similar to the common cold or a viral infection and are often mistaken for the latter diagnoses. Advanced disease may be recognizable by virtue of the shock-like symptoms and characteristic chest radiograph abnormality, but by then, the disease progression is rapid and treatment is ineffectual. Gram’s stains and cultures should be obtained on blood samples of patients in whom anthrax is suspected. Sputum from patients seldom yields positive smears or cultures. Serologic diagnosis of anthrax can be made by means of a microhemagglutination test specific for the PA component of the toxin. These tests are available through state health department laboratories. Suspicious Gram’s stains should be reported to the CDC for further evaluation.14 15 Antibiotics and supportive care in an intensive care setting are the mainstay of therapy. Antitoxin used in the Sverdlovsk epidemic is no longer available for human use. The anthrax bacillus is highly susceptible to penicillin, amoxicillin, chloramphenicol, doxycycline, erythromycin, streptomycin, and ciprofloxacin, but resistant to third-generation cephalosporins (Table 3 ).28 Table 3. Antibiotics Used in the Treatment of Anthrax Antibiotics ------------------------------------------------------------------------------ -- Susceptible Penicillin Amoxicillin Chloramphenicol Doxycycline Erythromycin Streptomycin Ciprofloxacin Clindamycin Resistant Third-generation cephalosporins Cefuroxime Sulfamethoxazole Trimethoprim Genetically engineered B anthracis strains resistant to penicillin Penicillin resistance is rare in naturally occurring strains. However, it is possible to manufacture resistant strains, which is a matter of great concern in the event of biological warfare. Penicillin G, 4 million units every 4 h; ciprofloxacin, 400 mg every 12 h; or doxycycline, 100 mg every 12 h, are dosages often used in the treatment of inhalational anthrax.12 ICUs are especially useful in the hemodynamic monitoring of patients and management of septic and hemorrhagic shock, the final common pathway linking all these patients. In addition, progressive respiratory insufficiency may necessitate the use of ventilatory support. -- The silver-list is a moderated forum for discussion of colloidal silver. To join or quit silver-list or silver-digest send an e-mail message to: [email protected] -or- [email protected] with the word subscribe or unsubscribe in the SUBJECT line. To post, address your message to: [email protected] Silver-list archive: http://escribe.com/health/thesilverlist/index.html List maintainer: Mike Devour <[email protected]>
