Infectious Diseases in Critical Care Medicine

Table 7

Assessing the Patient for Selected Category B and C Agents

Pathogen (incubationperiod)

Systemic symptoms

Central nervoussystem

Cardiorespiratory

Gastrointestinal

Skin, joints, andmucous membranes Miscellaneous

Category B pathogens

Brucellosis

(Brucella

species) (10 days–3 mo)

Fever (sometimes

intermittent),malaise, headache,myalgias,arthralgias, backpain, malodorousdiaphoresis, chills,weight loss.

Depression is common;

change in mentalstatus, Other compli-cations: acute andchronic meningitis,encephalitis, myelitis,radiculoneuritis,brain abscess,epidural abscess,demyelination, andvasculitis, cerebralaneurysms/subarachnoidalhemorrhage

Endocarditis.

Anorexia, nausea,

vomiting, diarrhea,or constipation inmajority of patients.Bad taste in mouth.

Sacroiliitis, spondylitis,

and large jointeffusions. Skinlesions are unusual(rashes, papules,ulcers, erythemanodosum,petechiae, purpura,vasculitis), cellulitisand abscesses,osteomyelitis.

Recurrent and persistent

disease occurs.

Uveitis is a late

complication. 7.9%and 0.7% of patientswith chronic or acutedisease respectivelyhave eyecomplications.

Hepatosplenomegaly

(20–30%),lymphadenopathy(10%), severepharyngitis,panniculitis.

Other complications: mixed

cryo-globulinemia, orchi-epididymitis, pancreatitis,Coombs-positiveautoimmune hemolyticanemia, cold agglutinin-associated hemolyticanemia, pancytopeniaand capillary leaksyndrome, acquiredprogressive spasticparaparesis, subacutethyroiditis.

454 Cleri et al.