Anthrax: Difference between revisions
Line 39: | Line 39: | ||
#[[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 | ||
#[[ | #[[Levo]] 500 mg qd | ||
#[[Doxycycline]] 100 mg bid | #[[Doxycycline]] 100 mg bid | ||
##(Peds) 2.5mg/kg IV q12h | ##(Peds) 2.5mg/kg IV q12h |
Revision as of 22:16, 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)
- Ecthyma gangrenosum
- Rat-bite fever (Streptobacillus monilifomis and Spirillum minus)
- Ulceroglandular tularemia
- Plague
- Glanders (Pseudomonas peudomallei)
- Rickettsialpox (Rickettsia akari)
- Orf (parapox virus)
- Staph lymphadenitis
- TB
- Leprosy
- Buruli ulcer (Mycobact ulcerans)
- Inhalational
- Acute bacterial mediastinitis
- Mycoplasma
- Legionnaire's
- Psittacosis
- Tularemia
- Q fever (Coxiella burnetti)
- Viral pneumonia
- Histoplasmosis
- Coccidiomycosis
- Ruptured Aortic Dissection
- 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