Anthrax

Anthrax is a notifiable condition. Bacillus anthracis spores are potential agents of biologic warfare as they are easily disseminated and are resistant to heat, light, and radiation.

Cutaneous anthrax is the most common type, accounting for approximately 95% of cases. Inhalation, ingestion, and injection anthrax, as well as anthrax meningitis, are less common.

Microbiology and pathology testing are used to confirm the diagnosis. Chest x-ray and CT scan are useful diagnostic tools in cases of inhalation anthrax.

Initial therapy includes treatment with empiric antimicrobial drugs and appropriate supportive therapy. Once susceptibilities are available, antibiotic treatment may need to be modified. Anthrax antitoxins may be used in some patients.

Postexposure prophylaxis is recommended to prevent infection after known or suspected exposure to aerolized B anthracis spores, and consists of a single antimicrobial drug (or an anthrax antitoxin as an alternative if antimicrobial drugs are not available), plus an anthrax vaccine, if indicated.

A rare zoonotic infection caused by the spore-forming, gram-positive soil organism Bacillus anthracis. Cutaneous disease as a result of direct inoculation of spores through the skin is the most common manifestation and accounts for more than 95% of cases.[1]Bower WA, Yu Y, Person MK, et al. CDC guidelines for the prevention and treatment of anthrax, 2023. MMWR Recomm Rep. 2023 Nov 17;72(6):1-47. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651316 http://www.ncbi.nlm.nih.gov/pubmed/37963097?tool=bestpractice.com However, fatal systemic illness due to spore ingestion, inhalation, or injection can occur. Exotoxin production can lead to shock, hypotension, and sudden death, necessitating early diagnosis and therapy. Inhalation anthrax is also known as woolsorters' disease. B anthracis is a tier 1 select agent and may be used as a bioterrorism agent.

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