pulmonary anthrax


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anthrax

 [an´thraks]
an infectious disease seen most often in cattle, horses, mules, sheep, and goats, due to ingestion of spores of Bacillus anthracis. It can be acquired by humans through contact with infected animals or their byproducts, such as carcasses or skins.

Anthrax in humans usually occurs as a malignant pustule or malignant edema of the skin. In rare instances it can affect the lungs if the spores of the bacillus are inhaled, or it can involve the intestinal tract when infected meat is eaten. The condition often is accompanied by hemorrhage, as the exotoxins from the bacillus attack the endothelium of small blood vessels. The condition is treated by the use of antibiotics such as penicillin and the tetracyclines. The malignant edema can be treated with intravenous hydrocortisone. The disorder is also known by a variety of names, including woolsorters' disease, ragpickers' disease, and charbon.
cutaneous anthrax anthrax due to lodgment of the causative organisms in wounds or abrasions of the skin, producing a black crusted pustule on a broad zone of edema.
gastrointestinal anthrax anthrax due to ingestion of poorly cooked meat contaminated with Bacillus anthracis, with deposition of spores in the submucosa of the intestinal tract, where they germinate, multiply, and produce toxin, resulting in massive edema, which may obstruct the bowel, hemorrhage, and necrosis.
inhalational anthrax a usually fatal form of anthrax due to inhalation of dust containing anthrax spores, which are transported to the regional lymph nodes where they germinate, multiply, and produce toxin, and characterized by hemorrhagic edematous mediastinitis, pleural effusions, dyspnea, cyanosis, stridor, and shock. It is usually an occupational disease, such as in persons who handle or sort contaminated wools and fleeces. Antimicrobial prophylaxis is used to prevent the condition. The Centers for Disease Control and Prevention has published interim guidelines for investigation and response to Bacillus anthracis infection. The evaluation of risk for exposure to aerosolized spores is of highest priority. Obtaining adequate samples, avoiding cross-contamination, and insuring proficient testing and evaluation of test results are all recommended.
meningeal anthrax a rare, usually fatal form of anthrax resembling typical hemorrhagic meningitis due to spread through the bloodstream of Bacillus anthracis from a primary focus of infection; manifestations include cerebrospinal fluid that is hemorrhagic and neurological signs and symptoms.
pulmonary anthrax inhalational anthrax.

pul·mo·nar·y an·thrax

a form of anthrax acquired by inhalation of dust containing Bacillus anthracis; there is an initial chill followed by pain in the back and legs, rapid respiration, dyspnea, cough, fever, rapid pulse, and extreme cardiovascular collapse.

pulmonary anthrax

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.

pulmonary anthrax

Inhalation anthrax, see there.

pul·mo·nar·y an·thrax

(pulmŏ-nar-ē anthraks)
Form acquired by inhalation of dust containing Bacillus anthracis; initial chill is followed by pain in the back and legs, rapid respiration, dyspnea, cough, fever, rapid pulse, and extreme cardiovascular collapse.

pulmonary anthrax

A serious form of ANTHRAX caused by inhalation of dust containing the spores of Bacillus anthracis . After an initial mild phase lasting for a few days, there is a severe illness with breathlessness, oedema of the chest and neck, shock and usually death within 24 hours.

pul·mo·nar·y an·thrax

(pulmŏ-nar-ē anthraks)
Form of anthrax acquired by inhalation of dust containing Bacillus anthracis.

anthrax

a peracute disease of all animal species, caused by Bacillus anthracis, and characterized by septicemia and sudden death. The causative bacteria form long-living spores which maintain the disease on a farm for many years. Significant necropsy findings include exudation of dark, tarry blood from the body orifices, failure of the blood to clot, absence of rigor mortis and splenomegaly. A dangerous zoonosis. Easily controlled by vaccination of livestock.

alimentary anthrax
infection resulting from the ingestion of animals dead of anthrax. Largely a human manifestation in developing countries.
anthrax belt
regions where anthrax is enzootic, where soil and climate favor persistence of the organism in soil and where routine efforts to control the disease are not sufficient. Outbreaks commonly follow climatic extremes of flood or drought.
cutaneous anthrax
anthrax due to lodgment of the causative organisms in wounds or abrasions of the skin, producing a black crusted pustule on a broad zone of edema. A common form of the disease in humans.
pulmonary anthrax
infection of the respiratory tract resulting from inhalation of dust or animal hair containing spores of Bacillus anthracis; an occupational disease of humans usually affecting those who handle and sort wools and fleeces (woolsorters' disease).
References in periodicals archive ?
Pulmonary anthrax causes severe breathing difficulty, but its initial symptoms may resemble a common cold.
It is the first case of pulmonary anthrax in America since 1975.
Of the 32 people known to have been exposed to the bug, three have died from pulmonary anthrax.
And in New Jersey, a female postal worker was tonight suspected of having contracted pulmonary anthrax.
Meanwhile, in the US, two postal workers in Washington DC have died of pulmonary anthrax.
Bob Stevens, a 63-year-old picture editor died last Friday of pulmonary anthrax, a rare form of the disease contracted by breathing in the spores.
Pulmonary anthrax is less common and creates flu-like symptoms and severe respiratory problems.
Occupational risk played a key role in suspicion of pulmonary anthrax infection; however, the symptoms of the suspected anthrax cases varied greatly from those of confirmed anthrax cases.
And, as fury mounted over "special treatment" for senators, congressmen and their staff, it was confirmed that yet another postal worker in New Jersey was fighting for life after contracting pulmonary anthrax.
In America it was confirmed that two postal workers who died on Monday had contracted pulmonary anthrax, while another worker in New Jersey is suspected of having contracted the infection.
Acute pulmonary anthrax and influenza present with nearly the same picture.
Bob Stevens, a 63-year-old British-born picture editor with The Sun, died last Friday of pulmonary anthrax, a rare form of the disease contracted by breathing in the spores.

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