Case 16 CONFIRMED
the patient who worked at
the same distribution center was admitted to the hospital with suspected inhalational anthrax. The patient had initially presented to the ED on
October 21 with complaints of 5 days of progressive fatigue, nausea,
vomiting, and diarrhea, and syncope. The patient was afebrile and had
orthostatic hypotension. A chest radiograph was obtained and reported to be
normal. The patient received intravenous fluids and was discharged. He
returned to the ED 26 hours later following another syncopal episode and
persistent gastrointestinal complaints. The patient was afebrile,
hypotensive, diaphoretic, and in respiratory distress. A second chest
radiograph and a chest CT revealed mediastinal lymphadenopathy and bilateral
pleural effusions. Subsequent review of the first chest radiograph revealed
an ill-defined area of increased density in the right subhilar region.
Laboratory evaluation revealed leukocytosis and hemoconcentration.
Antimicrobial therapy was initiated, and the patient was mechanically
ventilated. Peripheral blood smear demonstrated gram-positive bacilli; blood
cultures grew gram-positive bacilli within 18 hours and were confirmed as
B. anthracis at CDC. The patient died on October 22.
Click for clinical details (Emerging Inf Diseases)
Click for more clinical details (.pdf file, JAMA, patient 1)
Click for news account of Joseph Curseen Jr. (10/26/01)
Click for additional news account of Joseph Curseen Jr. (10/31/01)
Click for news account of unfolding events (11/19/01)
Click for news account of comparative medical care (11/27/01)
Click for MMWR account of Brentwood postal facility anthrax testing
(12/21/01)
Click for renaming of Brentwood Post Office after Joseph Curseen, Jr.(9/26/02)
Click for lawsuits by family against hospital and hospital against Federal
government (11/18/05)
Click for remembrance service for Joseph Curseen, Jr. five years later (10/25/06)