Back to Infectious Diseases
Anthrax is an infection caused by
that occurs primarily in cattle and other herbivores. Humans become
spores are introduced into the body by contact with infected animals
or contaminated animal products, insect bites, ingestion, or
inhalation. Aerosolized spores of
Bacillus anthracis have the potential for use in biological
warfare or bioterrorism. Cutaneous anthrax is most common and is characterized
by the development of a localized skin lesion with a central eschar surrounded
by marked nonpitting edema. Inhalation anthrax (woolsorters' disease)
typically involves hemorrhagic mediastinitis, rapidly progressive systemic
infection, and a very high mortality rate. Gastrointestinal anthrax is
rare and is associated with a high mortality rate.
There are 4 types of presentation:
Cutaneous (skin) anthrax: A small red macule (red area)
develops within days after inoculation of B. anthracis spores into skin.
During the next week, the lesion typically progresses through papular
and vesicular or pustular stages to the formation of an ulcer with a
blackened necrotic eschar surrounded by a highly characteristic expanding
zone of edema.
Hemorrhagic pneumonia (wool sorter?s disease): The presenting
symptoms of inhalational anthrax (woolsorters' disease) resemble those
of severe viral respiratory diseases. Early diagnosis of inhalational
anthrax that occurs naturally or as a consequence of biological warfare
or bioterrorism is difficult. After 1 to 3 days the patient presents
with increasing fever, dyspnea, stridor, hypoxia, and hypotension usually
leading to death within 24 h.
Gastrointestinal anthrax: Symptoms of gastrointestinal anthrax
are variable and include fever, nausea and vomiting, abdominal pain,
diarrhea, and sometimes rapidly developing
Diarrhea is occasionally massive in volume. The major features of oropharyngeal
anthrax are fever, sore throat, dysphagia, painful regional lymphadenopathy,
and toxemia; respiratory distress may be evident. The primary lesion
is most often located on the tonsils.
Blood spread in rare cases may lead to meningitis with bloody
Bacterial examination of the blood or skin smear from skin anthrax
may reveal the diagnosis. Serology with examination of the antibody levels
in blood will also confirm anthrax.
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Antibiotics are indicated depending on the
severity and type of infection. Ciprofloxacin, penicillin are the most
active antibiotics against
Bacillus anthracis. Infected dead animals should be burnt and their
housing area disinfected.
Vaccines are available for exposed workers and animals.