ID-Bioterrorism Flashcards
Describe the gram stain of anthrax? What do you see on imaging? What are the clinical features
Gram positive box car shaped
You see a widened mediastinum on CXR
Clinical features include low grade fever, myalgia, malaise, headache, cough, chest pain, dyspnea. You often see a black eschar cutaneous lesion
How is anthrax diagnosed?
PCR of blood, tissue samples
How do you treat suspected anthrax?
levo, cipro, or doxy, should be given to all people with suspected case of anthrax
What is the monoclonal ab available for anthrax?
Raxibacumab
What are the clinical symptoms of smallpox?
High fever, headache, vomiting, backache
Rash: first appears on the buccal and pharyngeal mucosa, then spreads to the skin: face, arms, legs, hands and feet
How does the smallpox rash evolve?
It evolves from macules, to papules, vesicles to pustules, and eventually crust over
How do you treat smallpox?
Supportive care
What do you do for people exposed to smallpox?
Given them vaccinia within three days.
What causes the plague?
Yersinia pestis, usually a bite from an infected flea but can also be aerosolized
How does pneumonic plague evolve? What are the clinical symptoms?
- It arises from hematogenous spread of a bubo (an infected, swollen lymph node) but may be primary from direct inhalation
- Sudden high fever, pleuritic chest discomfort, productive cough, hemoptysis
Treatment for the plague?
Streptamicin or gentamicin for 7-10 days
What is prophylaxis for the plague?
Doxycycline or levofloxacin
What causes botulism?
Clostridium botulinum
What are the ways we would be concerned of botulism becoming a biological threat?
inhaled or ingested in food
What are the clinical features of botulism?
cranial nerve palsies and a descending flaccid paralysis
How do you diagnose botulism
Confirm it’s presence in blood, stool samples
How do you treat botulism?
Anti-botulinum toxin and supportive care
How do you prevent botulism?
Antibotulinum antitoxin
How could tularemia be used as a biological threat?
Requires low inoculation to infect someone
Describe pneumonic tularemia
nonproductive cough, dyspnea, substernal or pleuritic chest pain
How is tularemia diagnosed best?
Culture and other testing data are often negative. PCR is really the only way to rapidly diagnose it.
How do you treat tularemia?
Severe disease: Streptomycin, gentamicin
Nonsevere disease: doxycycline, ciprofloxacin
