Subject(s)
Anthrax/epidemiology , Respiratory Tract Infections/epidemiology , Skin Diseases, Bacterial/epidemiology , Bioterrorism/statistics & numerical data , Centers for Disease Control and Prevention, U.S. , Humans , Inhalation Exposure , Occupational Exposure , Postal Service , Respiratory Tract Infections/microbiology , Skin Diseases, Bacterial/microbiology , United States/epidemiologyABSTRACT
Anthrax caused by Bacillus anthracis in humans is rare. Two recent outbreaks that were intentionally caused occurred among postal employees, politicians, and journalists in the United States. This has caused tremendous fear, and our experience with these "anthrax incidents" has changed our views on the natural history of this disease in people. In this paper, we review the lifecycle and biology of this micro-organism. Anthrax that occurs from a weaponized form of this micro-organism has a specific clinical presentation that requires a suspicion of anthrax exposure to be diagnosed. New methods of testing for anthrax have been developed and may simplify diagnosis in the future. The range of illness caused by B. anthracis from the molecular level to the clinical symptoms is discussed. We also review the diagnostic criteria and differential diagnosis as well as treatment of this condition.
Subject(s)
Anthrax/diagnosis , Anthrax/epidemiology , Anthrax/therapy , Bacillus anthracis/pathogenicity , Humans , United States , VaccinationABSTRACT
Most cancer patients experience at least one emergency during the course of the disease. This paper reviews the diagnosis and treatment of tumor lysis syndrome, hypercalcemia of malignancy, superior vena cava syndrome, spinal cord compression, strokes and seizures, and treatment-related emergencies.
Subject(s)
Emergencies , Neoplasms/complications , Humans , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Hypercalcemia/therapy , Risk Factors , Seizures/diagnosis , Seizures/etiology , Seizures/therapy , Spinal Cord Compression/diagnosis , Spinal Cord Compression/etiology , Spinal Cord Compression/therapy , Stroke/diagnosis , Stroke/etiology , Stroke/therapy , Superior Vena Cava Syndrome/diagnosis , Superior Vena Cava Syndrome/etiology , Superior Vena Cava Syndrome/therapy , Tumor Lysis Syndrome/diagnosis , Tumor Lysis Syndrome/etiology , Tumor Lysis Syndrome/therapyABSTRACT
Anthrax is a naturally occurring organism with a low incidence of infection. There are no known cases of human-to-human transmission. Bioterrorism-related anthrax in the United States has been seen in three high-risk groups: (1) postal workers, (2) politicians and their staffs, and (3) the press. It appears as though the bioterrorism-related anthrax cases of fall 2001 have been transmitted through the US Postal Service. The authors present a case in which a person at high risk for anthrax exposure was inadequately treated and had symptoms that do not fall into any specific category of disease. It emphasizes the need for someone who has been started on prophylaxis for anthrax to complete a full 60-day course of treatment. It also shows the effectiveness of antibiotic therapy, even in those with high exposure to weaponized anthrax. Further, we would like to suggest that there may exist a new clinical entity of "aborted anthrax infection."
