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    6 Anthrax

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    Rizal Moehammad
    1) Anthrax is caused by Bacillus anthracis and can present as cutaneous, inhalational, or gastrointestinal disease. 2) Cutaneous anthrax presents as a painless skin lesion that progresses to a black eschar. Inhalational anthrax causes initial flu-like symptoms followed by sepsis. 3) Gastrointestinal anthrax presents with abdominal pain, vomiting, and bloody diarrhea. Ciprofloxacin is the recommended treatment.

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    6 Anthrax

    Uploaded by

    Rizal Moehammad
    94 views13 pages
    1) Anthrax is caused by Bacillus anthracis and can present as cutaneous, inhalational, or gastrointestinal disease. 2) Cutaneous anthrax presents as a painless skin lesion that progresses to a black eschar. Inhalational anthrax causes initial flu-like symptoms followed by sepsis. 3) Gastrointestinal anthrax presents with abdominal pain, vomiting, and bloody diarrhea. Ciprofloxacin is the recommended treatment.

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    1) Anthrax is caused by Bacillus anthracis and can present as cutaneous, inhalational, or gastrointestinal disease. 2) Cutaneous anthrax presents as a painless skin lesion that progresses to a black eschar. Inhalational anthrax causes initial flu-like symptoms followed by sepsis. 3) Gastrointestinal anthrax presents with abdominal pain, vomiting, and bloody diarrhea. Ciprofloxacin is the recommended treatment.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    94 views13 pages

    6 Anthrax

    Uploaded by

    Rizal Moehammad
    1) Anthrax is caused by Bacillus anthracis and can present as cutaneous, inhalational, or gastrointestinal disease. 2) Cutaneous anthrax presents as a painless skin lesion that progresses to a black eschar. Inhalational anthrax causes initial flu-like symptoms followed by sepsis. 3) Gastrointestinal anthrax presents with abdominal pain, vomiting, and bloody diarrhea. Ciprofloxacin is the recommended treatment.

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    ANTHRAX

    Etiology:
    Bacillus anthracis
    (Zoonosis)
    Clinical findings

    Symptoms and signs


    1. Cutaneous anthrax

    2. Inhalational anthrax bioterrorism

    3. Gastrointestinal anthrax
    CUTANEUS ANTRAKS
    1. Cutaneous anthrax
    Incubation period 2 weeks

    The initial lesion is an erythematous papule, often on an


    exposed area of skin that vesiculated and then ulcerated and
    undergoes necrosis, ultemately progressing to a purple to black
    schar:
    Painless pain indicates secondary infection

    The surrounding area is edematous and vesicular but not purulent


    Clinical findings: Cutaneous anthrax (cont.)

    Regional adenopathy,

    Fever

    Malaise

    Headache

    Nausea and vomiting


    2. Inhalational anthrax
    Two stages
    Begins on average 10 days after exposure. Although a longer incubation
    period of up to 6 weeks
    Nonspecific viral-like symptoms:

    Fever

    Malaise

    Headache

    Dyspnea

    Cough

    Congestion of the nose, throat and larynx


    2. Inhalational anthrax (cont.)

    Two stages

    Anterior chest pain is an early symptom of mediastinitis.


    Whithin hours to a few days, progression to the fulminant stage
    of infection occurs in which signs and symptoms of sepsis
    predominate:

    Delirium, obtudation, or meningeal irritation suggest an


    accopanying hemorrhagic meningitis
    3. Gastrointestinal anthrax
    INHALATION ANTRAKS
    3. Gastrointestinal anthrax
    Symptoms begin 2-5 days after ingestion of meat contaminated with
    anthrax spores:
    Fever

    Diffuse abdominal pain

    Rebound abdominal tenderness

    Vomiting

    Constipation or diarrhea

    Emesis is blood-tinged or coffee-ground

    The stool may be blood tinged or melenic

    Bowel perforation
    GASTROINTESTINAL ANTRAKS
    A. Suatu edema berat pada
    lengkungan duodenum pada
    intestinal anthrax dengan
    suatu pembesaran limfonodus
    ( di antara jari dokter bedah di
    atas ).
    B. Segmen usus yang sama
    setelah dibuka. Terdapat
    edema, nekrosis, dan mukosa
    hemoragik. Sebuah eschar
    sentral ( pada tanda panah )
    dan tersisa nodul kecil yang
    mengelilingi pada lesi
    cutaneus anthrax
    Clinical findings 4. The oropharyngeal form of the
    disease is characterized by:

    Local lymphadenopathy

    Cervical edema

    Dysphagia

    Upper respiratory tract obstruction


    Differential diagnosis
    Types of anthrax DD
    -Cutaneous anthrax -Ecthyma gangrenosum, rat bite fever,
    ulceroglandular tularemia, plague,
    glanders, rickettsialpox, orf, cutaneous
    mycobacterial infection

    -Inhalational anthrax -mediastinitis

    -Gastrointestinal anthrax -Bowel obtruction, perforates


    viscus,peritonitis, gastroenteritis, peptic
    ulcer disease
    Treatment
    Antimicrobial Recommended dosee
    agents
    First-line agents - Ciprofloxacin, 2 x 500 mg daily orally or 2 x 400
    mg/ 12 hours intravenously (IV) DOC
    - Docycycline, 100 mg every 12 hours orally or IV

    Second-line agents - Amoxicillin 3 x 500 mg daily orally


    - Penicillin G, 2 mU every 4 hours intravenously

    Alternative agents - Rifampin, 10 mg/kg/d orally or intravenously


    with in vitro activity - Clindamycin, 450-600 mg every 8 hours orally/iv
    - Clarithromycin, 500 mg twice daily
    - Erythromycin, 500 mg mg every 6 hours iv
    - Vancomycin, 1 g every 12 hours
    - Imipenem, 500 mg every 6 hours iv

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