Anthrax-Like Illness Puzzles Doctors

[3nd3r]

ASSOCIATED PRESS

BALTIMORE -- The case of an ailing postal inspector who tests negative for anthrax but was exposed to it and displays symptoms similar to it raises new questions about the disease.

THE WORKER, a 37-year-old man, has been sick for more than two months and is currently recuperating at home.

He inspected equipment in the Brentwood postal facility, which handled a letter containing anthrax spores. Two workers there died from the disease.

After anthrax was first discovered at the plant, the postal inspector was given Cipro as a preventive. He took it one day, missed two doses, and began feeling ill shortly after that. He was given a blood test, and it turned up negative for anthrax, but his doctors say the antibiotic could have wiped out signs of the bacteria.

But chest X-rays also failed to show the telltale signs of the disease. Other tests that might have picked up signs of anthrax apparently were not given.

Without any medical evidence, the Centers for Disease Control and Prevention is not classifying the case as anthrax.

Still, the mans doctors at Sinai Hospital in Baltimore reported in the Journal of the American Osteopathic Association this week that they strongly suspect he suffers from anthrax.

The case could expand the spectrum of what is considered an anthrax infection, his doctors said.

It raises the question of: Is there a range of illness? said Dr. Tyler Cymet, lead author of the case report. Can you get very ill just by being exposed and not getting the disease?

Clinicians are open to the possibility that patients can react differently to the same infection, and that there may be different ways anthrax can manifest itself, said Dr. Gregory Poland of the Mayo Clinic.

The likelihood of this being all or nothing that you get exposed and without treatment you die is likely not going to be the full story here, said Poland, who advises the CDC on bioterrorism drugs and vaccines.

The doctors did not identify the patient, but The (Baltimore) Sun identified him as William R. Paliscak Jr. of Edgewater.

Cymet, who treated Paliscak about a week after his exposure to anthrax, said his patient had low oxygen levels in his blood, severe shortness of breath, high fever, fluid in his lungs, a cough, swollen lymph nodes and chest pain.

Tests ruled out fungal and viral infections and autoimmune disease. His symptoms improved, but then he relapsed, and he was hospitalized for 45 days while he received intravenous antibiotics.

The workers symptoms, Cymet said, were just as serious as those associated with anthrax.

Through Cymet, Paliscak declined to be interviewed. His wife, Allison, who works at the osteopathic hospital where her husband was treated, told The Sun, Its been beyond an ordeal. The good part is, unlike a lot of other people, hes still alive.