MedPix® Patient Chart - Case No: 4153 :: - Review Images

Postal worker with flu-like symptoms.

Specific exam and lab values were not avaiable.

- Review Images for PT: 4153

Chest Radiograph, Patient A, Day 4: Widened mediastinum with medistinal adenopathy, hilar fullness and small bilateral pleural effusions.

CT (noncontrast), Patient A, Day 4: Confirmed the hilar and mediastinal adenopathy, particularly subcarinal adenopathy, and small bilateral pleural effusions.


CT (IV contrast), Patient A, Day 5: Interval enlargement of the adenopathy and increased pleural effusion to approximately 60% of his chest volume. With the use of IV contrast in this study, the adenopathy shows enhancement and the central necrotic center is well demonstrated consistent with hemorrhagic adenpathy.

- Review Images for PT: 4153

Malignant neoplasm
Aggressive Infection

- Review Images for PT: 4153

Dx: Inhalation Anthrax

Dx Confirmed by:

- Read

Both patients recieved IV antibiotic therapy.

Two patients presented 4 days after exposure to inhalation anthrax. Inital examinations demponstrated massive medistinal adenopathy and small bilateral pleural effusions. The follow up CT examination on Patient A demonstrates enlargement of the adenopathy and increased pleural effusion to approximately 60% of the chest volume. With the use of IV contrast in this study, the adenopathy shows enhancement and the central necrotic region is well demonstrated - consistent with hemorrhagic adenpathy. This patient also had airspace disease which is non specific. However, in autopsy cases inhalation anthrax was shown to have focal hemorrhagic necrotizing pneumonic lesions.