CBRNE - Staphylococcal Enterotoxin B Workup

Updated: Dec 31, 2015
  • Author: Bruce A Gleason, MD; Chief Editor: Duane C Caneva, MD, MSc  more...
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Workup

Laboratory Studies

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  • Although staphylococcal enterotoxin B (SEB) can be confirmed through enzyme-linked immunosorbent assay or by rapid fluorescence-based immunoassays of tissue or body fluids, diagnosis is largely clinical and by epidemiologic factors rather than by assays of tissue or body fluids. [13]

  • Neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate may be observed in SEB intoxication.

  • Toxin may be identified in nasal swabs from persons exposed to respiratory aerosol within the preceding 12-24 hours, offering an avenue of early diagnosis in the battlefield.

  • Rabbit studies have shown that accumulation of SEB in the serum is transient but is detectable in the urine for up to several hours after exposure. Urine samples should be collected for testing. [14]

  • Most patients develop a significant antibody response to SEB and acute and convalescent sera should be drawn for retrospective analysis and possibly diagnosis.

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Imaging Studies

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  • Radiographs of the chest appear normal unless the patient has had significant aerosolized exposure, in which case pulmonary edema or an ARDS presentation is evident.

  • Routine abdominal films for SEB gastroenteritis are not necessary but may exhibit significant intestinal gas with no free air.

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Other Tests

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  • Other tests are indicated based on the patient's physiologic condition or progress of the disease syndrome.

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