Author ORCID Identifier

Date of Award


Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Alexander Kirpich

Second Advisor

Katherine Hendricks

Third Advisor

Marissa Person


INTRODUCTION: Pleural effusions, pericardial effusions, and ascites are potential, severe complications of any form of anthrax. Previous research suggests that draining pleural fluid decreases mortality among inhalation anthrax patients, but research into other anthrax presentations remains to be accomplished.

AIM: To determine if thoracentesis (paracentesis) increased survival among anthrax patients with pleural effusions (ascites).

METHODS: Using historical anthrax case data, we summarized demographic characteristics, prior health status, signs and symptoms, vital signs, complications, and imaging findings between 1) patients with fluid collection and those without; 2) patients with fluid collection who lived and those who died; 3) patients with each fluid collection type. We then conducted univariate logistic regression to calculate the odds of survival for pleural effusion (ascites) patients by thoracentesis (paracentesis) status, stratified by phase of presentation (prodromal or fulminant) and treatment status.

RESULTS: Only 15% of patients experienced any form of fluid collection. Small numbers prohibited the calculation of odds ratios for survival for the majority of treatment categories. Where odds ratios could be calculated, no statistically significant differences were found.

DISCUSSION: The analysis was limited by small sample sizes within each treatment category, which is the result of the rarity of pleural effusions and ascites in data available to us. The problem was further exacerbated by missing data on thoracentesis (paracentesis) status and treatment status. Future research on the topic is recommended when more data becomes available. Additional cases could come from either future English-language publications or existing foreign-language publications.


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