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anthrax

An often fatal bacterial infection that occurs when Bacillus anthracis endospores (primarily of grazing herbivorous—cattle, sheep, horses, mules—origin) enter via skin abrasions, inhalation or orally.

Diagnosis
ELISA for capsule antigens (95+% senstivity) and protective antigens (72% sensitivity); detection of exotoxins in blood is unreliable.
 
Prevention
Prophylaxis (six weeks) with doxycycline or ciprofloxacin; vaccination with anthrax vaccine absorbed; decontamination with aerosolised formalin.
 
Management
Penicillin, doxycycline; chloramphenicol, erythromycin, tetracycline, ciprofloxacin if (allergic to penicillin).

Anthrax, clinical forms 
Inhalation (Anthrax pneumonia, inhalational anthrax, pulmonary anthrax)
An almost universally fatal form due to inhalation of 1 to 2 µm pathogenic endospores, which are deposited in alveoli, engulfed by macrophages and germinate en route to the mediasitinal and peribronchial lymph nodes, producing toxins.
 
Clinical
Mediastinal widening, pleural effusions, fever, nonproductive cough, myalgia, malaise, haemorrhage, cyanosis, SOB, stridor, shock, death; often accompanied by mesenteric lymphadenitis, diffuse abdominal pain and fever.
 
Cutaneous
Once common among handlers of infected animals (e.g., farmers, wool-sorters, tanners, brushmakers and carpetmakers).
 
Clinical
Carbuncle, a cluster of boils that later ulcerates, resulting in a hard black centre surrounded by bright red inflammation; rare cases that become systemic are almost 100% fatal.
 
Gastrointestinal
After ingesting contaminated meat (2 to 5 days); once ingested, spores germinate, causing ulceration, haemorrhagic and necrotising gastroenteritis.
 
Clinical
Fever, diffuse abdominal pain with rebound tenderness, melanic stools, coffee grounds vomit, fluid and electrolyte imbalances, shock; death is due to intestinal perforation or anthrax toxemia.

Oropharyngeal
Uncommon; follows ingestion of contaminated meat.
 
Clinical
Cervical oedema, lymphadenopathy (causing dysphagia), respiratory difficulty.

Anthrax meningitis
A rare, usually fatal complication of GI or inhalation anthrax, with death occurring 1 to 6 days after onset of illness.
 
Clinical
Meningeal symptoms, nuchal rigidity, fever, fatigue, myalgia, headache, nausea, vomiting, agitation, seizures, delirium, followed by neurologic degeneration and death.

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anthrax.