Infectious Diseases in Critical Care Medicine

Table 6

Assessing the Patient for Category A Agents (

Continued

)

Pathogen(incubation period)

Systemic symptoms

Central nervoussystem

Cardiorespiratory

Gastrointestinal

Skin and mucousmembranes

Miscellaneous

Yellow fever severe

disease

Abrupt onset of high

fever, severeheadache

Severe headache.

Hypotension, heart

failure, prolongationof the PR and QTintervals.

Nausea, vomiting,

abdominal, backloin, and limb pain.Dehydration,jaundice, epigastricpain, vomiting, andgastrointestinalbleeding develop.

Bleeding from nose

and gums.

Patients may recover after 3

days or temporarilyimprove for 24 hr beforedeteriorating. Recovery in3–4 days to 2 wk or deathon the 7th–10th day.

Rabies

(4 days to

19 yrs. Most casespresent in 1–2 mo.75% present in20–90 days afterexposure).

Prodrome

(1–10 days):anxiety, depression,gastro-intestinalsymptoms, pain,and/or paresthesiaat site ofinoculation.

Symptomatic (furious)

rabies—80% ofpatients: agitation,hallucination, mixedwith lucid periods,autonomicdysfunction,hydrophobia,aerophobia, cranialnerve abnormalities,coma.

Myocarditis, cardiac

arrhythmia,congestive heartfailure

Nausea, vomiting,

diarrhea, ileus,gastrointestinalbleeding.

Source

: From Refs. 1, 5, 6, and 23–30.

Bioterrorism Infections in Critical Care 453