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JOURNAL publishes details of first anthrax death

Updated:

BOSTON (AP) _ The precise technical details of the first death in the anthrax attacks are being published in a medical journal by the doctors who diagnosed the infection.

While the report contains no surprises, it could help other doctors recognize such cases if they encounter them.

It will be published in the Nov. 29 issue of the New England Journal of Medicine. Because of its public health importance, the journal posted it Thursday on its Web site.

Dr. Larry M. Bush outlined the clinical details of diagnosing inhaled anthrax in Bob Stevens, 63, a photo editor at the supermarket tabloid The Sun, on Oct. 2 at Atlantis Medical Center in Atlantis, Fla.

Four days before, Stevens had felt muscle ache, nausea and fever while on a trip to North Carolina. At the hospital, he was lethargic, disoriented and running a fever of almost 103.

A spinal tap showed bacilli, a form of bacteria, and he was put on high-dose penicillin. The probable diagnosis of anthrax came 18 hours later, after the hospital lab grew the bacteria in a culture plate.

A few hours after he was admitted to the hospital, Stevens had a seizure and was put on a breathing machine. His blood pressure dropped and his fever rose to 104.

On his third day in the hospital, despite aggressive treatment, his blood pressure fell further. He went into cardiac arrest and could not be revived.

The case ``highlights the importance of physicians' ability to recognize potential cases in the identification and treatment of diseases associated with biologic terrorism,'' the doctors wrote.

Stevens was the first of four people to die of inhaled anthrax. Six others have survived the disease.
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