Volume 20, Number 2—February 2014
Dispatch
Lethal Factor and Anti-Protective Antigen IgG Levels Associated with Inhalation Anthrax, Minnesota, USA
Mark D. Sprenkle
, Jayne Griffith, William Marinelli, Anne E. Boyer, Conrad P. Quinn, Nicki T. Pesik, Alex Hoffmaster, Joseph Keenan, Billie A. Juni, and David D. Blaney
, Jayne Griffith, William Marinelli, Anne E. Boyer, Conrad P. Quinn, Nicki T. Pesik, Alex Hoffmaster, Joseph Keenan, Billie A. Juni, and David D. Blaney
Table 1
Laboratory test results for patient being assessed and treated for inhalation anthrax, Minnesota, USA, 2011*
| Test | Patient value, day of hospitalization† |
Reference value‡ | |||||
|---|---|---|---|---|---|---|---|
| 1 | 3 | 4 | 5 | 7 | 9 | ||
| Hematologic | |||||||
| White blood cell count (×103/mm3) | 7.6 | 13.9 | 27.4 | 12.0 | 10.7 | 15.6 | 4.0–10.0 |
| Neutrophils (%) | 73.4 | 82.3 | 81.0 | 70.9 | 75.0 | 75.0 | 34.0–70.0 |
| Lymphocytes (%) | 13.2 | 9.3 | 8.0 | 19.8 | 15.3 | 17.0 | 20.0–40.0 |
| Monocytes (%) | 12.4 | 8.0 | 9.0 | 7.2 | 5.4 | 3.0 | 4.0–10.0 |
| Hemoglobin (g/dL) | 17.0 | 17.0 | 16.6 | 14.5 | 12.8 | 12.7 | 13.1–17.5 |
| Platelet count (×103/mm3) |
132 |
118 |
125 |
117 |
211 |
333 |
150–400 |
| Serum chemistry | |||||||
| Sodium (mEq/dL) | 139 | 129 | 121 | 125 | 128 | 132 | 135–148 |
| Potassium (mEq/dL) | 3.9 | 4.2 | 3.8 | 3.7 | 3.4 | 4.3 | 3.5–5.3 |
| Chloride (mEq/dL) | 95 | 89 | 84 | 86 | 92 | 98 | 100–108 |
| Bicarbonate (mEq/dL) | 36 | 34 | 31 | 33 | 30 | 31 | 22–30 |
| Serum urea nitrogen (mg/dL) | 17 | 16 | 18 | 29 | 40 | 27 | 8–22 |
| Creatinine (mg/dL) | 1.0 | 0.9 | 0.8 | 1.2 | 1.3 | 0.9 | 0.7–1.4 |
| Glucose (mg/dL) | 248 | 229 | 158 | 198 | 186 | 189 | 70–100 |
| Calcium (mg/dL) | 8.7 | 8.6 | 8.6 | 7.7 | 7.3 | 7.3 | 8.5–10.5 |
| Lactate (mmol/L) | ND | ND | 2.2 | ND | ND | ND | 0.7–2.1 |
| Albumin (g/dL) | 3.6 | 3.0 | ND | 2.4 | 2.1 | 2.1 | 3.4–5.0 |
| Alkaline phosphatase (U/L) | 58 | 60 | ND | 63 | 76 | 80 | 38–126 |
| Aspartate aminotransferase (U/L) | 43 | 37 | ND | 65 | 44 | 35 | 5–40 |
| Alanine aminotransferase (U/L) | 92 | 102 | ND | 144 | 141 | 97 | 7–56 |
| Total bilirubin (mg/dL) | 0.6 | 0.6 | ND | 0.5 | 1.1 | 0.6 | 0.1–1.3 |
| Troponin I (ng/mL) |
ND |
ND |
ND |
0.025 |
ND |
ND |
<0.034 |
| Coagulation | |||||||
| Prothrombin time (s) | ND | ND | 11.5 | 11.6 | ND | ND | 9.0–12.5 |
| International normalized ratio (s) | ND | ND | 1.1 | 1.1 | ND | ND | 0.8–1.2 |
| Partial thromboplastin time (s) | ND | ND | ND | 27.9 | ND | ND | 25.0–38.0 |
| Dimerized plasmin fragment (ng/mL) | ND | ND | ND | 670 | ND | ND | <229 |
*ND, not done.
†Initial admission was to a community hospital; on day 4, the patient was transferred to a tertiary referral center.
‡Reference values during patient’s hospitalization at a tertiary referral center.
Page created: January 17, 2014
Page updated: January 17, 2014
Page reviewed: January 17, 2014
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