Pediatric Terrorism and Disaster Preparedness: Tables 4.4a and b

Table 4.4a. Diagnostic Tests for Anthrax

Anthrax Type	Diagnostic Tests
Cutaneous	Vesicular fluid and blood culture (anaerobic and aerobic)
Inhalational	Blood culture, cerebrospinal fluid (CSF), chest radiograph, computer tomography (CT) scan
Gastrointestinal	Blood culture

Table 4.4b. Adjunctive Diagnostic Tests for Anthrax

Test	Comments
Complete Blood Count (CBC)	White blood cell (WBC) count may be normal or slightly increased. Increased neutrophils or band forms common. Leukopenia or lymphocytosis does not support diagnosis of anthrax.
Chest radiograph	Frequently abnormal in inhalational anthrax; may show signs of mediastinal widening, paratracheal or hilar fullness, pleural effusions, pulmonary infiltrates (uni- or multilobar), and mediastinal lymphandenopathy; changes may be subtle and better defined on chest CT.
Nasal swab	May assist in epidemiologic investigations but should not be relied on as a guide for prophylaxis or treatment of individual patients.

Test

Comments

Complete Blood Count (CBC)

White blood cell (WBC) count may be normal or slightly increased.

Increased neutrophils or band forms common.

Leukopenia or lymphocytosis does not support diagnosis of anthrax.

Chest radiograph

Frequently abnormal in inhalational anthrax; may show signs of mediastinal widening, paratracheal or hilar fullness, pleural effusions, pulmonary infiltrates (uni- or multilobar), and mediastinal lymphandenopathy; changes may be subtle and better defined on chest CT.

Nasal swab

May assist in epidemiologic investigations but should not be relied on as a guide for prophylaxis or treatment of individual patients.

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