ANTHRAX (Сибирская Язва)

Anthrax is an infectious disease caused by bacteria genus Bacillus anthracis, characterized by a number of dermatological signs presenting mainly in the cutaneous form and systemic symptoms especially in the septic form, which can be lethal if not treated properly.

Classification
Localized form  – Cutaneous anthrax	Generalized (septicaemic) Form – Septic anthrax
Malignant: Carbuncle Pustule	1.      Pulmonary anthrax Inhalation anthrax Ragpicker’s disease Woolsorter’s disease 2.      Gastrointestinal anthrax 3.      Anthrax septicaemia 4.      Other forms of anthrax Anthrax meningitis 5.      Anthrax, unspecified

Pathogen – Bacillus Anthracis

Epidemiology

The source of infection – sick pets

Mechanism of transmission – by means of contact (commonly), aerogenic, Alimentary (nutritional), Transmissive (from a bite or scratch of infected animals).

Clinical picture

The incubation period ranges between 2 and 14 days.

Cutaneous anthrax

Start gradually.

Carbuncle Form – the consistent development of stains, papules, vesicles, ulcers with dark brown bottom, raised edges and serous-hemorrhagic discharge. Furthermore, secondary “daughter” vesicle(s) may appear on the edges of ulcer(s).

Tissue edema arising on the periphery of a carbuncle is characteristic. However, when triggered a gelatinous shake is observed in it (Stefano symptom).

Regionally increased lymph nodes

Edematous form – the emergence and development of edema, usually followed by subsequent secondary necrosis and small carbuncle.

Bullous form – the formation of bubbles with hemorrhagic fluid, which is formed at the opening of the ulcer.

Erysipeloid form – the emergence of a large number of bubbles with a clear liquid, which remain after the opening ulcers.

The differential diagnosis is carried out with boils, carbuncles, erysipelas, erysipeloid, plague, and tularemia.

Septic anthrax

Develops as a secondary process due to the progression of Cutaneous anthrax (with inadequate therapy and the presence of concomitant adverse factors) or as a result of an aerogenic infection (rag-pickers disease, болезнь тряпичников).

Expressed intoxication syndrome: fever (subfebrile) reaching 39 – 40 ° C, chills.

Pneumonic syndrome: The physical and radiographic evidence of pneumonia and pleurisy.

Involvement of the gastrointestinal tract: Cutting pains in the abdomen, nausea, vomiting blood, bloody diarrhea, intestinal paresis, peritonitis.

Complications: toxic shock, meningoencephalitis, hemorrhagic pulmonary edema, gastrointestinal bleeding.

The differential diagnosis is carried out with plague, tularemia, and sepsis.

Diagnosis

Diagnosis: mainly based on the clinical and epidemiological picture.

Laboratory – bacterioscopic and bacteriological methods.

Serological methods are not standardized.

Skin testing for anthrax

A sample of fluid is taken from a suspicious dermal lesion and/or a biopsy (small tissue sample) may be taken and analyzed in a laboratory for signs of cutaneous anthrax.(becomes positive after the fifth day of illness).

Treatment

Causal treatment

Localized forms are managed by penicillin dosage up to 12 million units / day.

Septic form is treated by levomycin or chloramphenicol at 4.0 – 5.0g / day, other cephalosporins and/or Specific globulins are also used.

Pathogenic Therapy – detoxifying agents, corticosteroids.

Verified by: Dr.Diab (January 7, 2017)

Citation: Dr.Diab. (January 7, 2017). Anthrax Classification Epidemiology Clinic and Treatment. Medcoi Journal of Medicine, 6(2). urn:medcoi:article16378.