By Gary M. White, MD
Anthrax is a zoonotic infection often acquired from farm animals caused by Bacillus anthracis.
- Although rarely seen in developed countries, it is fairly common in developing nations, especially among people who live in the country and have frequent contact with farm animals.
- There are some traditions that put people at risk. For example, two children are described who developed anthrax after contaminated cow's blood was applied to their foreheads as part of a ritual [PD 2002;19;36].
The primary skin lesion is often a nondescript, painless, and pruritic papule that appears 3-5 days after the introduction of the bacterium or its endospores. In 24-36 hours, the lesion forms a vesicle that undergoes central necrosis and drying, leaving a characteristic black eschar surrounded by edema and a number of purplish vesicles. The diagnosis is suspected clinically and confirmed by direct examination of gram-stained smears (e.g., showing gram-positive spore-forming bacilli) or culture of the organism.
Most cases of anthrax respond well to penicillin G. An anthrax vaccine has been approved for routine distribution.
Obiltoxaximab (ANTHIM) is a chimeric IgG antibody direct against a component of the Anthrax toxin. It is given as treatment of and prophylaxis against Anthrax. It is given IV in combination with antibiotics.
N Engl J Med 2009; 361:178
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