Anthrax history and symptoms: Difference between revisions

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Latest revision as of 20:25, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

The symptoms of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection). The cutaneous type of anthrax is characterized by a skin blister that evolves into an ulcer with a black center, muscle pains, fever, and vomiting. The gastrointestinal type may include symptoms of fever, chills, sore throat, painful swallowing, and abdominal pain. The symptoms of the inhalation type of anthrax are fever, chills, fatigue, sore throat, and shortness of breath. The symptoms of the injection type are usually similar to those of cutaneous anthrax; however, the disease may spread through the body faster. The symptoms of the injection type of anthrax include fever, chills, skin ulcer, and subcutaneous or muscular abscess. A history of exposure to contaminated animal materials, occupational exposure, and living in an endemic area is crucial when considering a diagnosis of anthrax.

Symptoms

The symptoms of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection).^[1]

Cutaneous Anthrax

Small painless skin sore that develops into a blister and later into a skin ulcer, with a black area at the center
Fever
Headaches
Muscle pain
Vomiting

Gastrointestinal Anthrax

Inhalation or Pulmonary Anthrax

Injection Anthrax

Fever and chills
Small blisters or bumps usually itchy, on the injection site
Painless skin ulcer with a black center that appears after the blisters or bumps
Swelling around the ulcer
Subcutaneous or intramuscular abscess on the site of injection

Image Gallery

Day 1 of development and resolution of uncomplicated cutaneous anthrax lesion.”Adapted from World Health Organization (WHO)^[2]
Day 2 - 3 of development and resolution of uncomplicated cutaneous anthrax lesion.”Adapted from World Health Organization (WHO)^[2]
Day 4 of development and resolution of uncomplicated cutaneous anthrax lesion.”Adapted from World Health Organization (WHO)^[2]
Day 6 of development and resolution of uncomplicated cutaneous anthrax lesion.”Adapted from World Health Organization (WHO)^[2]
Day 11 of development and resolution of uncomplicated cutaneous anthrax lesion.”Adapted from World Health Organization (WHO)^[2]

References

↑ "Anthrax symptoms".
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 "World Health Organization".

Template:WikiDoc Sources

[CDC-1] "Anthrax symptoms".

[WHO-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 "World Health Organization".

[1]

[2]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Anthrax}}
-{{CMG}}
+{{CMG}}; {{AE}} {{JS}}
 ==Overview==
-===Pulmonary===
+The symptoms of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection).  The [[cutaneous]] type of anthrax is characterized by a skin [[blister]] that evolves into an [[ulcer]] with a black center, [[muscle pains]], [[fever]], and [[vomiting]].  The [[gastrointestinal]] type may include symptoms of [[fever]], [[chills]], [[sore throat]], [[painful swallowing]], and [[abdominal pain]].  The symptoms of the inhalation type of anthrax are [[fever]], [[chills]], [[fatigue]], [[sore throat]], and [[shortness of breath]].  The symptoms of the injection type are usually similar to those of [[cutaneous anthrax]]; however, the disease may spread through the body faster. The symptoms of the injection type of anthrax include [[fever]], [[chills]], [[skin ulcer]], and [[subcutaneous]] or [[muscular]] [[abscess]].  A history of exposure to contaminated animal materials, occupational exposure, and living in an endemic area is crucial when considering a diagnosis of anthrax.
-Respiratory infection in humans initially presents with cold or [[flu-like symptoms]] for several days, followed by severe (and often fatal) respiratory collapse. Historical mortality was 92%, but, when treated early (seen in the [[2001 anthrax attacks]]), observed mortality was 45%.<ref name=boobs>{{cite journal |author=Bravata DM, Holty JE, Liu H, McDonald KM, Olshen RA, Owens DK |title=Systematic review: a century of inhalational anthrax cases from 1900 to 2005 |journal=Ann Intern Med |volume=144 |issue=4 |pages=270–80 |date=February 2006 |pmid=16490913 }}</ref> Distinguishing pulmonary anthrax from more common causes of respiratory illness is essential to avoiding delays in diagnosis and thereby improving outcomes. An algorithm for this purpose has been developed.<ref name="kyriacou">{{cite journal |author=Kyriacou DN, Yarnold PR, Stein AC, Schmitt BP, Soltysik RC, Nelson RR, Frerichs RR, Noskin GA, Belknap SM, Bennett CL |title=Discriminating inhalational anthrax from community-acquired pneumonia using chest radiograph findings and a clinical algorithm |journal=Chest |volume=131 |issue=2 |pages=489–96 |date=February 2007 |pmid=17296652 |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=17296652 |doi=10.1378/chest.06-1687}}</ref>  Illness progressing to the fulminant phase has a 97% mortality regardless of treatment.
-A lethal infection is reported to result from inhalation of about 10,000–20,000 spores, though this dose varies among host species.<ref>{{Cite web|url=http://www.medicinenet.com/script/main/art.asp?articlekey=18812&page=2 |title=Anthrax, Then and Now |publisher=MedicineNet.com |accessdate=13 August 2008}}</ref> As with all diseases, it is presumed that there is a wide variation to susceptibility with evidence that some people may die from much lower exposures; there is little documented evidence to verify the exact or average number of spores needed for infection. Inhalational anthrax is also known as Woolsorters' or Ragpickers' disease as these professions were more susceptible to the disease due to their exposure to infected animal products. Other practices associated with exposure include the slicing up of animal horns for the manufacture of buttons, the handling of hair bristles used for the manufacturing of brushes, and the handling of animal skins. Whether these animal skins came from animals that died of the disease or from animals that had simply laid on ground that had spores on it is unknown. This mode of infection is used as a bioweapon.
+==Symptoms==
+The [[symptoms]] of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection).<ref name=CDC>{{cite web | title = Anthrax symptoms | url = http://www.cdc.gov/anthrax/basics/symptoms.html }}</ref>
+===Cutaneous Anthrax===
+* Small painless [[skin]] [[sore]] that develops into a [[blister]] and later into a [[skin ulcer]], with a black area at the center
+* [[Fever]]
+* [[Headaches]]
+* [[Muscle pain]]
+* [[Vomiting]]
-===Gastrointestinal===
+===Gastrointestinal Anthrax===
-Gastrointestinal infection in humans is most often caused by eating anthrax-infected meat and is characterized by serious gastrointestinal difficulty, [[hematemesis|vomiting of blood]], severe diarrhea, acute inflammation of the intestinal tract, and loss of appetite. Some lesions have been found in the intestines and in the mouth and throat. After the bacterium invades the bowel system, it spreads through the bloodstream throughout the body, making even more toxins on the way. Gastrointestinal infections can be treated but usually result in fatality rates of 25% to 60%, depending upon how soon treatment commences.<ref name="CDC-Anthrax">{{Cite web|title=Anthrax Q & A: Signs and Symptoms |work=Emergency Preparedness and Response |publisher=Centers for Disease Control and Prevention |year=2003 |url=http://www.bt.cdc.gov/agent/anthrax/faq/signs.asp |accessdate=19 April 2007 }}</ref>  This form of anthrax is the rarest form.  In the United States, there have only been two  official cases, the first reported in 1942 by the CDC and the second reported in 2010 that was treated at the Massachusetts General Hospital.<ref name="nejm.com">{{Cite web|title=Case 25-2010 — A 24-Year-Old Woman with Abdominal Pain and Shock |url=http://www.nejm.org/doi/full/10.1056/NEJMcpc1003887}}</ref><ref name="cdc.gov">{{Cite web|title=Gastrointestinal Anthrax after an Animal-Hide Drumming Event --- New Hampshire and Massachusetts, 2009 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5928a3.htm}}</ref>  It is the only known case of survival from GI anthrax in the U.S.
+* [[Fever]] and [[chills]]
+* [[Flushing]] and [[red eyes]]
+* [[Headache]]
+* [[Fainting]]
+* Swelling of the neck or neck glands
+* [[Sore throat]]
+* [[Painful swallowing]]
+* [[Hoarseness]]
+* [[Nausea]]
+* [[Vomiting]], especially [[bloody vomiting]]
+* [[Stomach pain]]
+* [[Abdominal distension]]
+* [[Diarrhea]] or [[bloody diarrhea]]
-===Cutaneous===
+===Inhalation or Pulmonary Anthrax===
-Cutaneous (on the skin) anthrax infection in humans shows up as a boil-like skin lesion that eventually forms an ulcer with a black center (eschar). The black eschar often shows up as a large, painless [[necrotic]] ulcer (beginning as an irritating and itchy skin lesion or blister that is dark and usually concentrated as a black dot, somewhat resembling bread mold) at the site of infection. In general, cutaneous infections form within the site of spore penetration between 2 and 5 days after exposure. Unlike bruises or most other lesions, cutaneous anthrax infections normally do not cause pain.<ref name="CDC-Anthrax" />
+* [[Fatigue]]
+* Body pain
+* [[Fever]] and [[chills]]
+* [[Sweating]]
+* [[Headache]]
+* [[Confusion]] or [[dizziness]]
+* [[Sore throat]]
+* [[Cough]]
+* [[Chest discomfort]]
+* [[Shortness of breath]]
+* [[Nausea]]
+* [[Vomiting]]
+* [[Stomach pain]]s
-Cutaneous anthrax is typically caused when bacillus anthracis spores enter through cuts on the skin.  This form of Anthrax is found most commonly when humans handle infected animals and/or animal products (e.g., the hide of an animal used to make drums).
+===Injection Anthrax===
+* [[Fever]] and [[chills]]
+* Small [[blisters]] or bumps usually itchy, on the injection site
+* Painless [[skin ulcer]] with a black center that appears after the [[blisters]] or bumps
+* Swelling around the [[ulcer]]
+* [[Subcutaneous]] or [[intramuscular]] [[abscess]] on the site of injection
+==Image Gallery==
+<gallery>
+Image:Cutaneous A1.png| Day 1 of development and resolution of uncomplicated cutaneous anthrax lesion.”<SMALL><SMALL>''[http://www.who.int/en//  Adapted from World Health Organization (WHO)]''<ref name="WHO">{{Cite web | title = World Health Organization | url = http://www.who.int/en/}}</ref></SMALL></SMALL>
+Image:CutaneousA2.png| Day 2 - 3 of development and resolution of uncomplicated cutaneous anthrax lesion.”<SMALL><SMALL>''[http://www.who.int/en//  Adapted from World Health Organization (WHO)]''<ref name="WHO">{{Cite web | title = World Health Organization | url = http://www.who.int/en/}}</ref></SMALL></SMALL>
+Image:CutaneousA3.png| Day 4 of development and resolution of uncomplicated cutaneous anthrax lesion.”<SMALL><SMALL>''[http://www.who.int/en//  Adapted from World Health Organization (WHO)]''<ref name="WHO">{{Cite web | title = World Health Organization | url = http://www.who.int/en/}}</ref></SMALL></SMALL>
+Image:CutaneousA4.png| Day 6 of development and resolution of uncomplicated cutaneous anthrax lesion.”<SMALL><SMALL>''[http://www.who.int/en//  Adapted from World Health Organization (WHO)]''<ref name="WHO">{{Cite web | title = World Health Organization | url = http://www.who.int/en/}}</ref></SMALL></SMALL>
+Image:CutaneousA5.png| Day 11 of development and resolution of uncomplicated cutaneous anthrax lesion.”<SMALL><SMALL>''[http://www.who.int/en//  Adapted from World Health Organization (WHO)]''<ref name="WHO">{{Cite web | title = World Health Organization | url = http://www.who.int/en/}}</ref></SMALL></SMALL>
+</gallery>
-Cutaneous anthrax is rarely fatal if treated,<ref name="boobs" /> because the infection area is limited to the skin, preventing the Lethal Factor, Edema Factor, and Protective Antigen from entering and destroying a vital organ.  Without treatment about 20% of cutaneous skin infection cases progress to [[toxemia]] and death.
 ==References==
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