A review of cutaneous anthrax and its outcome

Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Journal of infection and public health 09/2010; 3(3):98-105. DOI: 10.1016/j.jiph.2010.07.004
Source: PubMed


Anthrax is still an endemic disease in some countries in the world and has become a re-emerging disease in western countries with recent intentional outbreak. The aim of this study was to review our clinical experience with cutaneous anthrax cases. From the patient's files, transmission of the diseases, clinical findings and severity of infection, treatment and outcome of patients were recorded. Twenty-two cases were diagnosed as cutaneous anthrax in the last 7 years. Of these cases, 10 cases were severe form of cutaneous anthrax, 10 cases were mild form and 2 cases were toxemic shock due to cutaneous anthrax. The incubation period was between 1 and 17 days. The main clinical characteristics of the cases with severe cutaneous anthrax were fever, hemorrhagic bullous lesions surrounded by an extensive erythema and edema, and leukocytosis. Two cases with toxemic shock had low systolic blood pressure, apathy and toxemic appearance, leukocytosis, hypoalbuminemia & hyponatremia. Penicillin G was given in 15 cases, amoxicillin in 4 and other antibiotics in 3 cases for 3-10 days. Skin lesion left deep tissue scar in 4 cases and were grafted. Physicians working in endemic areas and also in western countries should be aware of all clinical forms of anthrax.

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    • "Seroreactivity to PA63 could also be observed in people who have been infected with Bacillus anthracis and survived. Since pulmonary and gastrointestinal Anthrax is usually fatal or debilitating, and since cutaneous Anthrax results in a characteristic black eschar, it is unlikely that prior Anthrax would be missed on a directed health questionnaire [50]–[52]. Thus, positive immune reactivity to PA63 would strongly suggest non-specific interaction of host antibodies with PA63 or prior exposure to an antigen with a shared epitope. We thus excluded samples that showed immunoreactivity against ETX and PA63 since these indicated equivocal results. "
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    • "If not promptly treated with antibiotics such as penicillin, anthrax can result in the death of 10–40% of patients and is fatal within as few as 24 h [6]. The most common of the three forms of this disease is cutaneous—with respiratory and gastrointestinal being the other two—having as clinical manifestations increased body temperature, and bullous lesions resulting in severe erythema, edema, and tissue necrosis [6, 7]. "
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