By Dag K.J.E. von Lubitz
An outstanding textual content for both evaluation or for an introductory direction for nurses, nursing scholars, physicians, and so on. Concise, up to date, effortless to take advantage of. sufficiently small to hold within the box besides. sensible choice for practitioners and professors.
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Extra info for Bioterrorism: Field Guide to Disease Identification and Initial Patient Management
Its symptoms are easily recognizable especially in adult patients, where no other disease can produce similarly intense dehydration. S. the lack of practical experience with cholera may result in the differential diagnosis of severe gastroenteritis. E. fm Page 30 Friday, August 8, 2003 8:14 AM GLANDERS AND MELIOIDOSIS These are zoonotic diseases. Glanders is caused by Burkholderia mallei and meliodiosis is caused by B. pseudomallei. Both are Gram-negative and present a “safety-pin” appearance. Infection in animals and humans is caused by inhalation or contamination of injuries.
E. 9oC or 105oF), tachycardia, tachypnea, and hypotension. E. fm Page 37 Friday, August 8, 2003 8:14 AM Laboratory Tests Ⅲ CBC: white blood count (WBC) elevated to 20,000 or greater; left shift is noted; WBC may be low in late septicemia Ⅲ Urinalysis: gross hematuria; red blood count (RBC) casts; proteinuria Ⅲ Arterial blood gas: possible hypoxia and/or acidosis Ⅲ Microscopy: smears from lymph node (bubo) aspirate, sputum, blood, or CSF Ⅲ Gram stain: Gram-negative pleomorphic coccobacilli Ⅲ Wright, Giemsa, and Wayson’s stains also useful; bipolar “safety-pin” structure Ⅲ Definitive diagnosis relies on culturing bacteria from blood, sputum, CSF, or bubo aspirates: – Slow growth: > 48 hours before cultures can be definitively identified – Optimal growth at 28∞C – Blood and bubo cultures positive in majority of patients (> 85%) – Sputum cultures positive only if lung involvement present Ⅲ Fluorescent antibody stain provides rapid diagnosis Ⅲ Fluorescent antibody titer: fourfold titer difference indicates infection Ⅲ PCR: insufficiently developed but very sensitive Ⅲ Laboratory procedures generating aerosols require Biosafety Level 3 containment; otherwise Biosafety Level 2 offers sufficient protection Treatment Plague is almost always fatal unless treatment is initiated within 24 hours of the onset of symptoms.
E. E. E. fm Page 52 Friday, August 8, 2003 8:14 AM Western Equine Encephalitis (WEE) Infants and elderly are particularly vulnerable (£10% mortality rate). E. fm Page 53 Friday, August 8, 2003 8:14 AM Laboratory Tests Ⅲ Viremia rarely detectable in patients with encephalitic symptoms Ⅲ Lymphocytic pleocytosis (10 to 400 mononuclear cells/ml) Ⅲ Virus can be isolated from throat swabs in initial 2 days of illness Equine Encephalitis Virus Identification Ⅲ Time consuming; may be performed only in Biosafety Level 3 laboratories Ⅲ Inoculation of cell culture or suckling mice with serum or throat swab specimens using Gold Standard Assay for VEE Serology Ⅲ Ⅲ Ⅲ Ⅲ IgM ELISA IgG ELISA Hemagglutination inhibition Complement fixation In patients without known prior exposure to VEE, diagnosis is confirmed by identifying IgM antibodies in a single sample taken 5 to 7 days after the onset of the disease.
Bioterrorism: Field Guide to Disease Identification and Initial Patient Management by Dag K.J.E. von Lubitz