Anthrax: Difference between revisions
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#No one < 24 died | #No one < 24 died | ||
== | ==Differential Diagnosis== | ||
#Cutaneous (painless) | #Cutaneous (painless) | ||
##Ecthyma gangrenosum | ##Ecthyma gangrenosum | ||
##Rat-bite fever (Streptobacillus monilifomis and Spirillum minus) | ##Rat-bite fever (Streptobacillus monilifomis and Spirillum minus) | ||
##Ulceroglandular tularemia | ##Ulceroglandular tularemia | ||
##Plague | ##[[Plague]] | ||
##Glanders (Pseudomonas peudomallei) | ##Glanders (Pseudomonas peudomallei) | ||
##Rickettsialpox (Rickettsia akari) | ##Rickettsialpox (Rickettsia akari) | ||
##Orf (parapox virus) | ##Orf (parapox virus) | ||
##Staph lymphadenitis | ##Staph lymphadenitis | ||
##TB | ##[[TB]] | ||
##Leprosy | ##Leprosy | ||
##Buruli ulcer (Mycobact ulcerans) | ##Buruli ulcer (Mycobact ulcerans) | ||
#Inhalational | #Inhalational | ||
##Acute bacterial mediastinitis | ##Acute bacterial [[mediastinitis]] | ||
##Mycoplasma | ##Mycoplasma | ||
##Legionnaire's | ##Legionnaire's | ||
| Line 27: | Line 27: | ||
##Viral pneumonia | ##Viral pneumonia | ||
##Histoplasmosis | ##Histoplasmosis | ||
##Coccidiomycosis | ##[[Coccidiomycosis]] | ||
##Ruptured | ##Ruptured [[Aortic Aneurysm]] | ||
##SVC syndrome | ##SVC syndrome | ||
##Silicosis | ##Silicosis | ||
| Line 37: | Line 37: | ||
==Treatment== | ==Treatment== | ||
#Cipro 500 mg bid or 30 mg/kg div q12 | #[[Cipro]] 500 mg bid or 30 mg/kg div q12 | ||
##(Peds)-20-30mg/kg IV q12h | ##(Peds)-20-30mg/kg IV q12h | ||
# | #[[Lev]]o 500 mg qd | ||
#Doxycycline 100 mg bid | #[[Doxycycline]] 100 mg bid | ||
##(Peds) 2.5mg/kg IV q12h | ##(Peds) 2.5mg/kg IV q12h | ||
#x 60 days | #x 60 days | ||
| Line 47: | Line 47: | ||
===Prophylaxis=== | ===Prophylaxis=== | ||
#Cipro (Adult)-500mg PO BID | #[[Cipro]] (Adult)-500mg PO BID | ||
##(Peds)-20-30mg/kg/d PO BID | ##(Peds)-20-30mg/kg/d PO BID | ||
#Doxy (Adult) 100mgPO BID | #[[Doxy]] (Adult) 100mgPO BID | ||
##(Peds) 2.5mg/kg PO BID | ##(Peds) 2.5mg/kg PO BID | ||
| Line 56: | Line 56: | ||
==Source == | ==Source == | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 06:05, 18 April 2014
Background
- Gm positive rod, tough spores
- Inhalational Anthrax: Russian accident at Sverdlovsk
- Incubation Period is 10 days
- No one < 24 died
Differential Diagnosis
- Cutaneous (painless)
- Inhalational
- Acute bacterial mediastinitis
- Mycoplasma
- Legionnaire's
- Psittacosis
- Tularemia
- Q fever (Coxiella burnetti)
- Viral pneumonia
- Histoplasmosis
- Coccidiomycosis
- Ruptured Aortic Aneurysm
- SVC syndrome
- Silicosis
- Sarcoidosis
Imaging
CXR/CT- Widened mediastinum representing hemorrhagic mediastinitis
Treatment
- Cipro 500 mg bid or 30 mg/kg div q12
- (Peds)-20-30mg/kg IV q12h
- Levo 500 mg qd
- Doxycycline 100 mg bid
- (Peds) 2.5mg/kg IV q12h
- x 60 days
PLUS vaccine: inactivated, cell-free immediately, 2 wks and then 4 wks
Prophylaxis
- Cipro (Adult)-500mg PO BID
- (Peds)-20-30mg/kg/d PO BID
- Doxy (Adult) 100mgPO BID
- (Peds) 2.5mg/kg PO BID