Anthrax infection.

Authors

Sweeney DA, Hicks CW, Cui X, et al. 

Institution

Medical Intensivist Program, Washington Hospital, Fremont, California, USA.

Source

Am J Respir Crit Care Med 2011 Dec 15; 184(12) :1333-41.

Abstract

Bacillus anthracis infection is rare in developed countries. However, recent outbreaks in the United States and Europe and the potential use of the bacteria for bioterrorism have focused interest on it. Furthermore, although anthrax was known to typically occur as one of three syndromes related to entry site of (i.e., cutaneous, gastrointestinal, or inhalational), a fourth syndrome including severe soft tissue infection in injectional drug users is emerging. Although shock has been described with cutaneous anthrax, it appears much more common with gastrointestinal, inhalational (5 of 11 patients in the 2001 outbreak in the United States), and injectional anthrax. Based in part on case series, the estimated mortalities of cutaneous, gastrointestinal, inhalational, and injectional anthrax are 1%, 25 to 60%, 46%, and 33%, respectively. Nonspecific early symptomatology makes initial identification of anthrax cases difficult. Clues to anthrax infection include history of exposure to herbivore animal products, heroin use, or clustering of patients with similar respiratory symptoms concerning for a bioterrorist event. Once anthrax is suspected, the diagnosis can usually be made with Gram stain and culture from blood or surgical specimens followed by confirmatory testing (e.g., PCR or immunohistochemistry). Although antibiotic therapy (largely quinolone-based) is the mainstay of anthrax treatment, the use of adjunctive therapies such as anthrax toxin antagonists is a consideration.

Mesh

Anthrax
Anti-Bacterial Agents
Bacillus anthracis
Bioterrorism
Gastrointestinal Diseases
Humans
Respiratory Tract Infections
Skin Diseases, Bacterial
Substance Abuse, Intravenous

Language

eng

Pub Type(s)

Journal Article Research Support, N.I.H., Intramural Review

PubMed ID

21852539