Anthrax
Diagnosis
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• Characteristic skin lesions of cutaneous anthrax begin as a pruritic, painless papule 2 to 5 days
after exposure. The lesion becomes vesicular, evolving into a necrotic black eschar with massive
surrounding oedema 24 to 36 hours later.
[54]
[Fig-2]
painless lesions (cutaneous) (common)
• Despite the massive oedema associated with cutaneous anthrax lesions, the wound is
characteristically painless.
oedema (cutaneous) (common)
• Occurs in 90% to 100% of cutaneous anthrax cases.
[54]
• Patients with injection anthrax typically present with massive oedema around the injection site often
leading to compartment syndrome or necrotising fasciitis.
[18]
influenza-like illness (inhalation) (common)
• Patients with inhalation anthrax typically describe an influenza-like illness, including fevers, myalgias,
and malaise.
[34]
• Symptoms of congestion and coryza are notably absent.
respiratory symptoms (inhalation) (common)
• Non-productive cough and chest discomfort may be seen in inhalation anthrax.
• Decreased breath sounds may suggest characteristic pleural effusions, but clinical signs of pneumonia
are variable or may be lacking.
oropharyngeal ulceration (ingestion) (uncommon)
• A rare complication of spore ingestion.
• Local oedema and sore throat are accompanied by pseudomembranous ulcers of the posterior
oropharynx, involving the tonsils in 72% of oropharyngeal cases.
[55]
Other diagnostic factors
lymphadenopathy (common)
• Regional lymphadenopathy occurs in 47% of cutaneous anthrax cases.
[54]
• In cases of inhalation anthrax, mediastinal and hilar lymphadenopathy were detected in 70% of
infected patients.
[34]
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