Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27025833
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Infect+Dis
2016 ; 62
(12
): 1537-1545
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Identifying Meningitis During an Anthrax Mass Casualty Incident: Systematic
Review of Systemic Anthrax Since 1880
#MMPMID27025833
Katharios-Lanwermeyer S
; Holty JE
; Person M
; Sejvar J
; Haberling D
; Tubbs H
; Meaney-Delman D
; Pillai SK
; Hupert N
; Bower WA
; Hendricks K
Clin Infect Dis
2016[Jun]; 62
(12
): 1537-1545
PMID27025833
show ga
BACKGROUND: Bacillus anthracis, the causative agent of anthrax, is a potential
bioterrorism agent. Anthrax meningitis is a common manifestation of B. anthracis
infection, has high mortality, and requires more aggressive treatment than
anthrax without meningitis. Its rapid identification and treatment are essential
for successful management of an anthrax mass casualty incident. METHODS: Three
hundred six published reports from 1880 through 2013 met predefined inclusion
criteria. We calculated descriptive statistics for abstracted cases and conducted
multivariable regression on separate derivation and validation cohorts to
identify clinical diagnostic and prognostic factors for anthrax meningitis.
RESULTS: One hundred thirty-two of 363 (36%) cases with systemic anthrax met
anthrax meningitis criteria. Severe headache, altered mental status, meningeal
signs, and other neurological signs at presentation independently predicted
meningitis in the derivation cohort and were tested as a 4-item assessment tool
for use during anthrax mass casualty incidents. Presence of any 1 factor on
admission had a sensitivity for finding anthrax meningitis of 89% (83%) in the
adult (pediatric) validation cohorts. Anthrax meningitis was unlikely in the
absence of any of these signs or symptoms (likelihood ratio [LR]- = 0.12 [0.19]
for adult [pediatric] cohorts), while presence of 2 or more made meningitis very
likely (LR+ = 26.5 [30.0]). Survival of anthrax meningitis was predicted by
treatment with a bactericidal agent (P = .005) and use of multiple antimicrobials
(P = .01). CONCLUSIONS: We developed an evidence-based assessment tool for
screening patients for meningitis during an anthrax mass casualty incident. Its
use could improve both patient outcomes and resource allocation in such an event.