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Infection by the bacterium Bacillus anthracis, which in humans is caused by contact with infected animals or animal products, and ingestion or inhalation of spores of the bacterium. Worldwide concern is focused on the potential use of anthrax as a bioterrorist weapon, in particular as an inhalational agent. The most common naturally occurring form of human anthrax is the cutaneous, and both the inhalational and gastrointestinal forms are quite rare. Anthrax in animals occurs throughout the world, primarily in herbivores, especially cattle, horses, goats, and sheep.
anthraxAn 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.
ELISA for capsule antigens (95+% senstivity) and protective antigens (72% sensitivity); detection of exotoxins in blood is unreliable.
Prophylaxis (six weeks) with doxycycline or ciprofloxacin; vaccination with anthrax vaccine absorbed; decontamination with aerosolised formalin.
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.
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.
Once common among handlers of infected animals (e.g., farmers, wool-sorters, tanners, brushmakers and carpetmakers).
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.
After ingesting contaminated meat (2 to 5 days); once ingested, spores germinate, causing ulceration, haemorrhagic and necrotising gastroenteritis.
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.
Uncommon; follows ingestion of contaminated meat.
Cervical oedema, lymphadenopathy (causing dysphagia), respiratory difficulty.
A rare, usually fatal complication of GI or inhalation anthrax, with death occurring 1 to 6 days after onset of illness.
Meningeal symptoms, nuchal rigidity, fever, fatigue, myalgia, headache, nausea, vomiting, agitation, seizures, delirium, followed by neurologic degeneration and death.