I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
This CXR demonstrates mediastinal widening which is pathognomonic for inhalation anthrax. The causative agent is Bacillus anthracis. Spores can be inhaled, phagocytosed by alveolar macrophages, and transported to mediastinal lymph nodes. After germinating, they cause a hemorrhagic necrosis of the thoracic lymph nodes draining the lungs and a hemorrhagic mediastinitis. Early clinical symptoms are nonspecific; after 2-3 days, the patient can have profound dyspnea, hypoxia, hypotension, and shock. Untreated inhalational anthrax is usually fatal.
Challenge: What is the causative organism?
Anthrax!
ReplyDeleteThe image is mediastinal widening.
Pathognomonic
ReplyDeleteThis CXR demonstrates mediastinal widening which is pathognomonic for inhalation anthrax. The causative agent is Bacillus anthracis. Spores can be inhaled, phagocytosed by alveolar macrophages, and transported to mediastinal lymph nodes. After germinating, they cause a hemorrhagic necrosis of the thoracic lymph nodes draining the lungs and a hemorrhagic mediastinitis. Early clinical symptoms are nonspecific; after 2-3 days, the patient can have profound dyspnea, hypoxia, hypotension, and shock. Untreated inhalational anthrax is usually fatal.
Source: UpToDate, CDC (bt.cdc.gov).