Inhalation Anthrax Case Study

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1. What, if any, special precautions need to be taken in caring for J.B., who was exposed to inhalation anthrax?
With no record of transmission via person to person, there are not special precautions that need to be taken, thus standard isolation precautions are used for patients with anthrax. Those in the household of persons exposed do not need prophylaxis unless they too have been exposed (Fowler & Shafazand, 2011, Antibiotic Therapies section, para. 2).
2. What clinical manifestations should you assess for in J.B.? When would you expect these symptoms to arise?
According to Fowler and Shafazand (2011, Clinical Presentation section, para. 4), there are two stages of inhalation anthrax, the first with an incubation period of one to six days with flu-like symptoms of malaise, non-productive cough, low grade fever, myalgia and intermittent sternal pressure for two to four days. It notes that following the first stage, the patient may seem to recover and will quickly transition into stage two where death may occur in 24-36 hours where acute shortness of breath, lymph node enlargement, hypoxemia, cyanosis and the rapid development of shock can occur(Fowler & Shafazand, 2011, Clinical Presentation section, para. 5). Other clinical manifestations include chills, dizziness and confusion, nausea, vomiting, abdominal pain, headaches and diaphoresis (Centers for Disease Control and Prevention (CDC), 2014).
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What is the treatment for anthrax exposure?
Medscape states early intervention has been seen to drastically improve patient outcomes in 8 of 15 patients with inhalation anthrax since 2001 with pleural effusion management, antibiotic, hemodynamic support, mechanical ventilation and antitoxin treatments (2014). According to Fowler, the US FDA has approved penicillin, doxycycline and ciprofloxacin for the treatment of inhalational anthrax (Fowler & Shafazand, 2011, Antibiotic Therapies section, para.

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