By Gary M. White, MD

Anthrax is a zoonotic infection often acquired from farm animals caused by Bacillus anthracis.


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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