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Virtual Naval Hospital

Medical Management of Biological Casualties Handbook

Appendix F: Specimens for Laboratory Diagnosis

U.S. Army Medical Research Institute of Infectious Diseases,Fort Detrick, Frederick, Maryland
Peer Review Status: Internally Peer Reviewed


Face or Acute & Nasal Blood Convalescent

Agent Swab1 Culture Smear Sera Stool Urine Other

Anthrax + + Pleural and + - - Lesion aspirates

CS fluids

mediastinal

lymph node

spleen

Brucellosis + + - + - - Bone marrow and

spinal fluid

cultures;

tissues, exudates

Cholera - - - + +

Plague + + Sputum + - - Lymph node, buboes, CSF, and

sputum culture

Tularemia + - +2 + - -

Q-fever - 4 Lesions + Lung, spleen,

lymph cultures

__________________________________________________

1Within 18-24 hours

2Fluorescent antibody test on infected lymph node smears. Gram stain has little value.

3Virus isolation from blood in appropriate containment.

4C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood

preferred. Culturing should not be done except in BL3 containment.

Face or Acute & Nasal Blood Convalescent

Agent Swab1 Culture Smear Sera Stool Urine Other

Congo-Crimean - 3 - + - - Liver

Hemorrhagic Fever

VEE - 3 - + - CSF

Clostridial + Wound + + -

Toxins tissues

SEB Toxin + - - + + + Lung

Ricin Toxin + - - + Spleen, lung,

kidney

 

1Within 18-24 hours

2Fluorescent antibody test on infected lymph node smears. Gram stain has little value.

3Virus isolation from blood in appropriate containment.

4C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood

preferred. Culturing should not be done except in BL3 containment.

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