Anthrax physical examination

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

Physical Examination

Appearance of the Patient

The appearance of the patients and physical exam will depend on the type of anthrax present in that patient.

Vitals

Temperature

Cutaneous Anthrax

• A fever is often present

Gastrointestinal Anthrax

• A fever is often present

Pulse

Rate

Cutaneous Anthrax

• Tachycardia is often present

Gastrointestinal Anthrax

• Tachycardia is often present

Inhalation or Pulmonary Anthrax

• Tachycardia is often present

Injection Anthrax

• Tachycardia is often present

Blood Pressure

Cutaneous Anthrax

• Hypotension may be present in severe systemic cases

Gastrointestinal Anthrax

• Hypotension may be present in severe systemic cases

Respiratory Rate

Gastrointestinal Anthrax

• Bradypnea may be present in more severe cases

Skin

Cutaneous Anthrax

• A rash is often present. Initially appearing as a small papule, which will then develop a ring of vesicles around the papule, possibly with exudate. Between days 5 - 7, initial papule will ulcerate to form a typical scar.
• Edema may be present
• Regional lymphadenitis may be present

Gastrointestinal Anthrax

• Edema may be present, particularly in the neck region
• Pallor may be present in cases of systemic anthrax with shock

Throat

Gastrointestinal Anthrax

• The throat may be erythematous if lesion located on oropharyngeal mucosa
• Exudate may be present if lesion located on oropharyngeal mucosa
• Tonsillar inflammation may be present if lesion located on oropharyngeal mucosa

Neck

Cutaneous Anthrax

• Lymph nodes may be present, particularly if initial lesion is located in that region

Gastrointestinal Anthrax

• Painful lymph nodes may be present
• Edema may be present in oropharyngeal anthrax

Abdomen

Cutaneous Anthrax

• Abdominal tenderness may be present, particularly if exuberant vomiting

Gastrointestinal Anthrax

• Abdominal distention may be present
• Abdominal tenderness may be present

Extremities

Cutaneous Anthrax

• Edema may be present, particularly around the initial lesion

Gastrointestinal Anthrax

• Edema may be present

Neurologic

Cutaneous Anthrax

• Mental status may be altered in case of severe systemic anthrax

Gastrointestinal Anthrax

• Mental status may be altered in case of severe systemic anthrax
• Coma may be present