Anthrax other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Several studies are used for the diagnosis and monitoring of anthrax. The polymerase chain reaction (PCR) test is ordered to confirm the virulence of the organism. In addition, lumbar puncture should be performed on admission when it is not contraindicated to search for the organism in the cerebrospinal fluid (CSF) and to to exclude other alternative diagnoses. Other diagnostic studies include an electrocardiogram and an echocardiogram to assess possible complications of anthrax such as atrial fibrillation and pericardial effusion.

Diagnostic Studies

Shown below is a table summarizing studies used to diagnose and monitor anthrax infection and its potential complications.^[1]^[2]^[3]

**Laboratory findings**
Test	Initial Findings	Serial Monitoring
PCR	Confirms virulence of organism by search for virulence factor genes Primers to the toxin gene Primer for the enzyme of capsule formation gene
Lumbar puncture	At admission unless contraindicated	Headache Confusion Other neurologic symptom If meningitis, meningeal signs will only be present at a later stage
Other imaging	As relevant to site of exposure Evaluate edema Evaluate inflammation Evaluate necrosis	For headache, confusion or other neurologic symptom If meningitis, meningeal signs will only be present at a later stage
EKG	Atrial fibrillation with rapid ventricular response
Echocardiogram	Evaluate for pericardial effusion Evaluate for myocardial dysfunction

References

↑ Hendricks, Katherine A.; Wright, Mary E.; Shadomy, Sean V.; Bradley, John S.; Morrow, Meredith G.; Pavia, Andy T.; Rubinstein, Ethan; Holty, Jon-Erik C.; Messonnier, Nancy E.; Smith, Theresa L.; Pesik, Nicki; Treadwell, Tracee A.; Bower, William A. (2014). “Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults”. Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130687. ISSN 1080-6040.
↑ “Anthrax in Humans and Animals” (PDF).
↑ “Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults”.

Overview