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http://dailynews.yahoo.com/h/ap/20020111/us/anthrax_mystery_illness_1.html

Friday January 11 6:07 PM ET
Postal Worker Case Puzzles Doctors
By GRETCHEN PARKER, Associated Press Writer

BALTIMORE (AP) - The case of an ailing postal inspector who tests negative
for anthrax but was exposed to it and displays symptoms similar to it raises
new questions about the disease.

The worker, a 37-year-old man, has been sick for more than two months and is
currently recuperating at home.

He inspected equipment in the Brentwood postal facility, which handled a
letter containing anthrax spores. Two workers there died from the disease.

After anthrax was first discovered at the plant, the postal inspector was
given Cipro as a preventive. He took it one day, missed two doses, and began
feeling ill shortly after that. He was given a blood test, and it turned up
negative for anthrax, but his doctors say the antibiotic could have wiped
out signs of the bacteria.

But chest X-rays also failed to show the telltale signs of the disease.
Other tests that might have picked up signs of anthrax apparently were not
given. Without any medical evidence, the Centers for Disease Control and
Prevention (news - web sites) is not classifying the case as anthrax.

Still, the man's doctors at Sinai Hospital here reported in the Journal of
the American Osteopathic Association (news - web sites) this week that they
strongly suspect he suffers from anthrax.

The case could expand the spectrum of what is considered an anthrax
infection, his doctors said.

``It raises the question of: Is there a range of illness?'' said Dr. Tyler
Cymet, lead author of the case report. ``Can you get very ill just by being
exposed and not getting the disease?''

Clinicians are open to the possibility that patients can react differently
to the same infection, and that there may be different ways anthrax can
manifest itself, said Dr. Gregory Poland of the Mayo Clinic.

``The likelihood of this being all or nothing - that you get exposed and
without treatment you die - is likely not going to be the full story here,''
said Poland, who advises the Centers for Disease Control and Prevention on
bioterrorism drugs and vaccines.

The doctors did not identify the patient, but The (Baltimore) Sun identified
him as William R. Paliscak Jr. of Edgewater.

Cymet, who treated Paliscak about a week after his exposure to anthrax, said
his patient had low oxygen levels in his blood, severe shortness of breath,
high fever, fluid in his lungs, a cough, swollen lymph nodes and chest pain.

Tests ruled out fungal and viral infections and autoimmune disease. His
symptoms improved, but then he relapsed, and he was hospitalized for 45 days
while he received intravenous antibiotics.

The worker's symptoms, Cymet said, were ``just as serious'' as those
associated with anthrax.

Through Cymet, Paliscak declined to be interviewed. His wife, Allison, who
works at the osteopathic hospital where her husband was treated, told The
Sun, ``It's been beyond an ordeal. The good part is, unlike a lot of other
people, he's still alive.''

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