Document Detail


Fatal inhalational anthrax with unknown source of exposure in a 61-year-old woman in New York City.
MedLine Citation:
PMID:  11851577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 61-year-old woman who was a New York City hospital employee developed fatal inhalational anthrax, but with an unknown source of anthrax exposure. The patient presented with shortness of breath, malaise, and cough that had developed 3 days prior to admission. Within hours of presentation, she developed respiratory failure and septic shock and required mechanical ventilation and vasopressor therapy. Spiral contrast-enhanced computed tomography of the chest demonstrated large bilateral pleural effusions and hemorrhagic mediastinitis. Blood cultures, as well as DNA amplification by polymerase chain reaction of the blood, bronchial washings, and pleural fluid specimens, were positive for Bacillus anthracis. The clinical course was complicated by liver failure, renal failure, severe metabolic acidosis, disseminated intravascular coagulopathy, and cardiac tamponade, and the patient died on the fourth hospital day. The cause of death was inhalational anthrax. Despite epidemiologic investigation, including environmental samples from the patient's residence and workplace, no mechanism for anthrax exposure has been identified.
Authors:
Bushra Mina; J P Dym; Frank Kuepper; Raymond Tso; Carmina Arrastia; Irina Kaplounova; Hasan Faraj; Agnieszka Kwapniewski; Christopher M Krol; Mayer Grosser; Jeffrey Glick; Steven Fochios; Athena Remolina; Ljiljana Vasovic; Jeffrey Moses; Thomas Robin; Maria DeVita; Michael L Tapper
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  287     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-19     Completed Date:  2002-02-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  858-62     Citation Subset:  AIM; IM    
Affiliation:
Section of Critical Care Medicine, Department of Medicine, Lenox Hill Hospital, 100 E 77th St, New York, NY 10021, USA. bmina@lenoxhill.net
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / diagnosis,  etiology
Anthrax / diagnosis*
Aortic Aneurysm / diagnosis
Bacillus anthracis / genetics,  isolation & purification*
Bioterrorism*
DNA, Bacterial / analysis
Diagnosis, Differential
Disseminated Intravascular Coagulation / etiology*
Environmental Exposure
Fatal Outcome
Female
Heart Failure / diagnosis
Hemothorax / etiology*,  radiography
Humans
Mediastinitis / etiology*,  radiography
Middle Aged
Multiple Organ Failure / etiology*
New York City
Pericardial Effusion / diagnosis,  etiology*
Pleural Effusion / etiology*,  radiography
Pneumonia / diagnosis
Respiratory Distress Syndrome, Adult / etiology
Respiratory Tract Infections / diagnosis*
Spores, Bacterial
Wegener Granulomatosis / diagnosis
Chemical
Reg. No./Substance:
0/DNA, Bacterial
Comments/Corrections
Comment In:
JAMA. 2002 Feb 20;287(7):898-900   [PMID:  11851584 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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