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Volume 7, Number 6—December 2001

Research

Bioterrorism-Related Inhalational Anthrax: The First 10 Cases Reported in the United States

John A. Jernigan*Comments to Author , David S. Stephens*†, David A. Ashford*, Carlos Omenaca‡, Martin S. Topiel§, Mark Galbraith¶, Michael Tapper#, Tamara L. Fisk*†, Sherif Zaki*, Tanja Popovic*, Richard F. Meyer*, Conrad P. Quinn*, Scott A. Harper*, Scott K. Fridkin*, James J. Sejvar*, Colin W. Shepard*, Michelle McConnell*, Jeannette Guarner*, Wun-Ju Shieh*, Jean M. Malecki**, Julie L. Gerberding*, James M. Hughes*, Bradley A. Perkins*, and members of the Anthrax Bioterrorism Investigation Team

Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Emory University School of Medicine, Atlanta, Georgia, USA; ‡Cedars Medical Center, Miami, Florida, USA; §Virtua Health, Mount Holly, New Jersey, USA; ¶Winchester Medical Center, Winchester, Virginia, USA; #Lenox Hill Hospital, New York City, New York, USA; **Palm Beach County Department of Public Health, West Palm Beach, Florida, USA

Article in French

Main Article

Table 3

Physical findings
Fever (>37.8°C) 7/10
Tachycardia (heart rate >100/min) 8/10
Hypotension (systolic blood pressure <110 mm Hg) 1/10
Laboratory results
White blood cell count (median, range) 9.8 x 103/mm3
Differential - neutrophilia (>70%) 7/10
Neutrophil band forms (>5%) 4/5
Elevated transaminasesa 9/10
(SGOT or SGPT > 40)
Hypoxemia 6/10
(Alveolar-arterial oxygen gradient >30 mm Hg on room air O2 saturation <94%)
Metabolic acidosis 2/10
Elevated creatinine (>1.5 mg/dL) 1/10
Chest X-ray findings
Any abnormality 10/10
Mediastinal widening 7/10
Infiltrates/consolidation 7/10
Pleural effusion 8/10
Chest computed tomography findings
Any abnormality 8/8
Mediastinal lymphadenopathy, widening 7/8
Pleural effusion 8/8
Infiltrates, consolidation 6/8

aSGOT = serum glutamic oxalacetic transaminase; SGPT = serum glutamic pyruvic transaminase

Main Article

1Members of the team who contributed to the work presented in this manuscript are J. Aguilar, M. Andre, K. Baggett, B. Bell, D. Bell, M. Bowen, G. Carlone, M. Cetron, S. Chamany, B. De, C. Elie, M. Fischer, A. Hoffmaster, K. Glynn, R. Gorwitz, C. Greene, R. Hajjeh, T. Hilger, J. Kelly, R. Khabbaz, A. Khan, P. Kozarsky, M. Kuehnert, J. Lingappa, C. Marston, J. Nicholson, S. Ostroff, T. Parker, L. Petersen, R. Pinner, N. Rosenstein, A. Schuchat, V. Semenova, S. Steiner, F. Tenover, B. Tierney, T. Uyeki, S. Vong, D. Warnock, C. Spak, D. Jernigan, C. Friedman, M. Ripple, D. Patel, S. Pillai, S. Wiersma, R. Labinson, L. Kamal, E. Bresnitz, M. Layton, G. DiFerdinando, S. Kumar, P. Lurie, K. Nalluswami, L. Hathcock, L. Siegel, S. Adams, I. Walks, J. Davies-Coles, M. Richardson, K. Berry, E. Peterson, R. Stroube, H. Hochman, M. Pomeranz, A. Friedman-Kien, D. Frank, S. Bersoff-Matcha, J. Rosenthal, N. Fatteh, A. Gurtman, R. Brechner, C. Chiriboga, J. Eisold, G. Martin, K. Cahill, R. Fried, M. Grossman, and W. Borkowsky.

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