Table 2.
Symptoms, Signs, Laboratory Tests, and Treatment by Severity Among Cutaneous Anthrax Patients, Kyrgyz Republic, 2005–2012
| Characteristic | Overall (N = 230) |
Mild (N = 167) |
Moderate (N = 44) |
Severe (N = 19) |
P Value | ||||
|---|---|---|---|---|---|---|---|---|---|
| n | (%) | n | (%) | n | (%) | n | (%) | ||
| Symptoms at presentation | |||||||||
| Fever or chills | 120 | (52.2) | 70 | (41.9) | 32 | (72.7) | 18 | (94.7) | <.0001 |
| Headache | 63 | (27.4) | 1 | (0.6) | 43 | (97.7) | 19 | (100) | <.0001 |
| Severe headache | 17 | (7.4) | 0 | (0) | 5 | (11.4) | 12 | (63.2) | <.0001 |
| Nausea or vomiting | 39 | (17.0) | 29 | (17.4) | 9 | (20.5) | 1 | (5.3) | .5 |
| Abdominal pain | 2 | (0.9) | 1 | (0.6) | 0 | (0) | 1 | (5.3) | .3 |
| Confusion | 2 | (0.9) | 0 | (0) | 0 | (0) | 2 | (10.5) | <.0001 |
| Malignant pustule edemaa | 226 | (98.3) | 165 | (98.8) | 43 | (97.7) | 18 | (94.7) | .5 |
| Vital signs at presentation | |||||||||
| Measured feverb | 54 | (23.5) | 0 | (0) | 37 | (84.1) | 17 | (89.5) | <.0001 |
| Tachycardiac | 11 | (4.8) | 0 | (0) | 0 | (0) | 11 | (57.9) | <.0001 |
| Tachypnead | 13 | (5.7) | 2 | (1.2) | 1 | (2.3) | 10 | (52.6) | <.0001 |
| Systolic hypertensione | 68 | (29.6) | 36 | (21.6) | 18 | (40.9) | 14 | (73.7) | <.0001 |
| Diastolic hypertensione | 28 | (12.2) | 7 | (4.2) | 8 | (18.2) | 13 | (68.4) | <.0001 |
| Laboratory tests | |||||||||
| White blood cell count ×109/L, mean (SD) | 7.2 | (2.2) | 6.8 | (2.0) | 8.4 | (2.3) | 8.6 | (2.6) | <.0001 |
| Lesion culture positivea | 117 | (50.9) | 87 | (52.1) | 21 | (47.7) | 9 | (47.4) | .6 |
| Lesion Gram stain positive | 106 | (46.1) | 76 | (45.5) | 24 | (54.5) | 6 | (31.6) | .2 |
| Blood culture positivea | 20 | (8.7) | 3 | (1.8) | 9 | (20.5) | 8 | (42.1) | <.0001 |
| Positive culture or Gram staina | 202 | (87.8) | 147 | (88.0) | 39 | (88.6) | 16 | (84.2) | .9 |
| Positive culture, Gram stain, or anthraxin testa | 213 | (92.6) | 157 | (94.0) | 40 | (90.9) | 16 | (84.2) | .3 |
| Treatment | <.0001 | ||||||||
| Monotherapy alone | 195 | (84.8) | 153 | (91.6) | 42 | (95.5) | 0 | (0) | |
| Sequential monotherapy | 15 | (6.5) | 14 | (8.4) | 1 | (2.3) | 0 | (0) | |
| Dual therapy alone | 3 | (1.3) | 0 | (0) | 1 | (2.3) | 2 | (10.5) | |
| Dual therapy followed by monotherapy | 17 | (7.4) | 0 | (0) | 0 | (0) | 17 | (89.5) | |
| Triple therapy | 0 | (0) | 0 | (0) | 0 | (0) | 0 | (0) | |
| Outcome | |||||||||
| Fatal | 0 | (0) | 0 | (0) | 0 | (0) | 0 | (0) | 1.0 |
| Length of hospital stay, mean (SD), days | 18.0 | (4.3) | 17.3 | (4.2) | 18.4 | (3.1) | 23.5 | (3.5) | <.0001 |
Abbreviation: SD, standard deviation.
There was 1 patient with unspecified malignant pustule edema results, 6 patients with unspecified blood culture results, 7 patients with unspecified lesion culture results, and 1 patient with unspecified anthraxin results.
Measured fever: recorded temperature at admission >38°C for patients aged ≥18 years or >38.5°C for patients aged 13–17 years.
Tachycardia: recorded heart rate at admission of ≥100 beats per minute for patients aged ≥18 years or >110 beats per minute for patients aged 13–17 years.
Tachypnea: recorded respiratory rate at admission of >20 breaths per minute for patients aged ≥18 years or >14 breaths per minute for patients aged 13–17 years.
Systolic and diastolic hypertension: recorded blood pressure at admission of systolic ≥130 mm Hg and diastolic ≥90 mm Hg, respectively.