Anthrax

Question 1

Organism for anthrax?

Answer 1

Bacillus anthracis - gram positive

Question 2

Reservoir for anthrax? Transmission?

Answer 2

Lives dormant in soil as spores
Spores are eaten, cause oral lesions, or through skin/lungs
Breach the anatomical border

Question 3

Clinical features of anthrax?

Answer 3

Excitable then depressed
Cardiac and respiratory and neuro

Clinical forms in humans
1. Skin (mortality <1%)
2. GI (mortality 50%)
3. Respiratory - pulmonary anthrax (90% mortality)
4. Meningitis (90% mortality)

Can also spread through injection. IVDUs in Scotland

Question 4

Skin manifestation of anthrax?

Answer 4

pimple/papule
Vesicle ring around it
Ulcerates, dries - eschar
No pain but painful lymph node
Necrotic centre

Question 5

Name the diagnosis
Main ∆∆

Answer 5

Anthrax
Spider bite

Question 6

GI anthrax - presentation?

Answer 6

Within 1-7 days
Acute gastroenteritis, vomiting, bloody
diarrhea, sometimes with oral-pharyngeal
ulcerations and cervical adenopathies

Question 7

Pulmonary anthrax presentation?

Answer 7

Haemorrhagic mediastinitis, pleural effusion, no pneumonia but presents with non specific respiratory symptoms
Can be inhalational, rapidly progressive

Question 8

Tests for anthrax?

Answer 8

Gram stain - gram positive
Culture
PCR and serology available

Question 9

Treatment of choice in anthrax?

Answer 9

Penicillin or fluroquinolones if non CNS

Penicillin + ciprofloxacin + linezolid/clinda + antitoxins (IgG) if meningeal disease