Table 1B.
Patient Characteristics, Presenting Signs and Symptoms, and Outcome for Childrena with Systemic Anthrax by Meningitis Status
| All Cases (n = 56) | Meningitis (n = 19) | No Meningitis (n = 37) | OR (95% CI)b | P-value c | |
|---|---|---|---|---|---|
| Patient Characteristic | |||||
| Age (years), mean±STD (n) | 10.7±6.0 (56) | 11.7±4.5 (19) | 10.1±6.7 (37) | NA | 0.4 |
| Age 0–1, % (n) | 12 (7) | 0 (0) | 19 (7) | Reference | |
| Age 2–5, % (n) | 14 (8) | 11 (2) | 16 (6) | 2.3 (0.3-∞) | 0.5 |
| Age 6–12, % (n) | 20 (11) | 37 (7) | 11 (4) | 12.4 (1.9-∞) | 0.02 |
| Age 13–17, % (n) | 54 (30) | 53 (10) | 54 (20) | 4.4 (0.8-∞) | 0.2 |
| Sexd | |||||
| Female, % (n) | 31 (17) | 32 (6) | 31 (11) | Reference | |
| Male, % (n) | 69 (37) | 68 (13) | 69 (24) | 1.0 (0.3–4.1) | >0.9 |
| Symptoms at Presentation | |||||
| Symptom onset to therapy (days), mean±STD (n) | 2.0 ±1.9 (23) | 2.0±2.0 (10) | 2.0±1.8 (13) | NA | >0.9 |
| Fever or chills, % (n) | 64 (36) | 84 (16) | 54 (20) | 4.4 (1.0–27.7) | 0.048 |
| Fatigue or malaise, % (n) | 11 (6) | 16 (3) | 8 (3) | 2.1 (0.3–17.4) | 0.7 |
| Nausea or emesis, % (n) | 30 (17) | 58 (11) | 16 (6) | 6.8 (1.7–30.5) | 0.004 |
| Headache, % (n) | 23 (13) | 47 (9) | 11 (4) | 7.1 (1.6–38.8) | 0.007 |
| Severe headache, % (n) | 7 (4) | 21 (4) | 0 (0) | 12.0 (1.9-∞) | 0.02 |
| Dyspnea, % (n) | 18 (10) | 5 (1) | 24 (9) | 0.2 (0.0–1.5) | 0.2 |
| Bleeding (e.g., hematemesis), % (n) | 16 (9) | 5 (1) | 22 (8) | 0.2 (0.0–1.8) | 0.2 |
| Cough, % (n) | 5 (3) | 5 (1) | 5 (2) | 1.0 (0.0–19.9) | >0.9 |
| Chest Pain, % (n) | 4 (2) | 0 (0) | 5 (2) | 0.8 (0.0–6.8) | 0.9 |
| Clinical Signs at Presentationd | |||||
| Temperature (°C), mean±STD (n) | 38.6±1.1 (34) | 38.9±1.2 (14) | 38.5±1.0 (20) | NA | 0.3 |
| Fever (>38.5 °C), % (n) | 60 (26) | 71 (10) | 55 (16) | 2.0 (0.4–10.8) | 0.5 |
| Hypothermia (<36 °C), % (n) | 0 (0) | 0 (0) | 0 (0) | ||
| Tachypnea, % (n) | 95 (19) | 88 (7) | 100 (12) | 0.7 (0.0–12.7) | 0.8 |
| Tachycardia, % (n) | 36 (10) | 25 (2) | 40 (8) | 0.5 (0.0–3.9) | 0.8 |
| Systolic hypotension, % (n) | 72 (13) | 100 (7) | 55 (6) | 6.3 (1.0-∞) | 0.1 |
| Fulminant phase, % (n) | 39 (22) | 58 (11) | 30 (11) | 3.2 (0.9–12.0) | 0.08 |
| Neurologic findings | |||||
| Altered mental status, % (n) | 29 (16) | 63 (12) | 11 (4) | 13.2 (3.0–74.6) | 0.0002 |
| Loss of consciousness, % (n) | 20 (11) | 53 (10) | 3 (1) | 36.7 (4.3–1781.6) | <.0001 |
| Meningeal signse, % (n) | 13 (7) | 39 (7) | 0 (0) | 28.8 (5.2-∞) | 0.0003 |
| Other neurologic deficitse, % (n) | 9 (5) | 28 (5) | 0 (0) | 17.4 (3.0-∞) | 0.005 |
| Outcome | |||||
| Mortalityd, % (n) | 44 (24) | 79 (15) | 25 (9) | 10.7 (2.6–56.2) | 0.0003 |
a
Children: 0–17 years old.
b
Exact logistic regression used to calculate Odds Ratios (OR) and 95% Confidence Intervals (CI).
c
P-values reported for continuous variables were results of an independent two-sample t-test and were associated with the OR for categorical variables.
d
Children systemic anthrax cases missing data include: sex (n=2), fever >38.5°C (n=13), hypothermia (n=13), tachypnea (n=36), tachycardia (n=28), systolic hypotension (n=38), and mortality (n=1).
e
Excludes suspected meningitis cases.