In inhalational anthrax, finding is:
Ans: b (mediastinal widening and pleural effusion) Ref: Davidson 20th ed/p.333.This is a direct pick from Davidson.Three forms of infection with Bacillus anthracis:-i) Cutaneous anthrax* Skin lesion due to occupational exposure to anthrax spores or bioterrorism.* Spores inoculated into exposed skin single lesion, an irritated papule on oedematous haemorrhagic base depressed black eschar. Pain infrequent.ii) Gastrointestinal anthrax* Ingestion of contaminated meat products* Caecum is the seat of infection* C/F - nausea, vomiting, anorexia, fever. Later severe abdominal pain and bloody diarrhoea. Toxaemia and death thereafter.iii) Inhalational anthrax* Rare. Associated with bioterrori sm.* Great mortality* C/F - fever, dyspnoea, cough, headache. Later on septicaemia.* CXR- mediastinal widening and pleural effusion.Investigation: Culture from Skin swabs.Management:Ciprofloxacin 500mg daily until penicillin susceptibility confirmed.Benzylpenicillin 600 000units i.m. 6 hourly.Aggressive fluid resuscitation. Ventilatory assistance in inhalational anthrax.Prophylaxis:Ciprofloxacin 500mg 12hourly for high risk from exposure.
Respiratory
Consolidation and pleural effusion
Mediastinal widening and pleural effusion
Bilateral patchy opacities with pleural effusion
None of the above
Mediastinal widening and pleural effusion