Inhalational anthrax often presents with flu-like symptoms. Kuehnert et al developed a score to help distinguish inhalational anthrax from influenza and other viral respiratory illnesses. The authors are from CDC.
Parameters:
(1) serum albumin
(2) heart rate
(3) nasal symptoms
(4) myalgias and/or arthralgias
(5) serum sodium
(6) headache
(7) hematocrit or hemoglobin
Parameter
Finding
Points
serum albumin
low
2
normal or elevated
0
heart rate
tachycardia (> 100 beats per minute)
2
normal or bradycardia
0
nasal symptoms
none
2
present
0
myalgias and/or arthralgias
neither
1
one or both
0
serum sodium
low
1
normal or increased
0
headache
none
1
present
0
hematocrit or hemoglobin
high for age and gender
1
normal or low for age and gender
0
where:
• The points assigned correspond to the strength of association in multivariate analysis.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum total score: 0
• maximum total score: 10
• The higher the score the more specific the diagnosis of inhalation anthrax but the lower the sensitivity.
Performance:
• A score >= 4 was 100% sensitive but 96% specific.
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