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==Overview==
==Overview==
The physical findings of [[anthrax]] infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection). Common findings associated with [[cutaneous]] anthrax infection include [[fever]], [[tachycardia]], [[skin rash]] with formation of a typical [[scar]], [[edema]], and [[lymphadenopathy]].  Signs of [[gastrointestinal]] anthrax infection include [[fever]], [[tachycardia]], [[mucosal]] [[ulcer]], [[edema]] in case of [[oropharyngeal]] lesion, and [[edema]] and [[pallor]] in more severe cases.  [[Inhalation]] anthrax is associated with [[fever]], [[tachycardia]], [[bradypnea]] in severe cases, [[pallor]], [[cyanosis]], and decreased [[heart]] and [[lung]] sounds in the presence of [[pleural effusion]].  Findings in anthrax infection due to injection include [[fever]], typical skin [[scar]] at the site of injection, [[edema]], and [[subcutaneous]] and/or muscular [[abscess]].
The physical findings of [[anthrax]] infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection). Common findings associated with [[cutaneous]] anthrax infection include [[fever]], [[tachycardia]], [[skin rash]] with formation of a typical [[scar]], [[edema]] and [[lymphadenopathy]]; with [[gastrointestinal]] anthrax infection include [[fever]], [[tachycardia]], [[mucosal]] [[ulcer]] and [[edema]] in case of [[oropharyngeal]] lesion and [[edema]] and [[pallor]] in more severe cases; with [[inhalation]] anthrax infection includes: [[fever]], [[tachycardia]], [[bradypnea]] in severe cases, [[pallor]], [[cyanosis]] and decreased [[heart]] and [[lung]] sounds in the presence of [[pleural effusion]]; and with anthrax infection due to injection include [[fever]], typical skin [[scar]] at the site of injection, [[edema]] and [[subcutaneous]] and/or muscular [[abscess]].


==Cutaneous Anthrax==
==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.<ref name=CDC>{{cite web | title = Anthrax symptoms | url = http://www.cdc.gov/anthrax/basics/symptoms.html }}</ref><ref name=WHO>{{cite web | title = Anthrax in Humans and Animals | url = http://www.who.int/csr/resources/publications/anthrax_web.pdf }}</ref>
===Vitals===
===Vitals===
====Temperature====
====Temperature====
=====Cutaneous Anthrax=====
* A [[fever]] is often present
* A [[fever]] is often present
=====Gastrointestinal Anthrax=====
* A [[fever]] is often present
=====Inhalation Anthrax=====
* A [[fever]] is often present
=====Injection Anthrax=====
* A [[fever]] is often present
====Pulse====
====Pulse====
=====Rate=====
=====Cutaneous Anthrax=====
* [[Tachycardia]] is often present
* [[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====
====Blood Pressure====
=====Cutaneous Anthrax=====
* [[Hypotension]] may be present in severe systemic cases
=====Gastrointestinal Anthrax=====
* [[Hypotension]] may be present in severe systemic cases
=====Inhalation Anthrax=====
* [[Hypotension]] may be present in severe systemic cases
* [[Hypotension]] may be present in severe systemic cases
===Skin===
* A [[rash]] is often present. The rash initially appears as a small [[papule]] which then develops a ring of [[vesicles]] around the [[papule]], possibly with [[exudate]]. Between days 5 - 7, the initial [[papule]] ulcerates to form a typical [[scar]].
* [[Edema]] may be present
* Regional [[lymphadenitis]] may be present


===Neck===
*[[Lymph nodes]] may be present, particularly if initial lesion is located in that region
===Abdomen===
*[[Abdominal tenderness]] may be present, particularly if there is exuberant vomiting
===Extremities===
*[[Edema]] may be present, particularly around the initial lesion
===Neurologic===
* The [[mental status]] may be altered in case of severe systemic anthrax
==Gastrointestinal Anthrax==
===Vitals===
====Temperature====
* A [[fever]] is often present
* [[Tachycardia]] is often present
====Blood Pressure====
* [[Hypotension]] may be present in severe systemic cases
====Respiratory Rate====
====Respiratory Rate====
=====Gastrointestinal Anthrax=====
* [[Bradypnea]] may be present in more severe cases
* [[Bradypnea]] may be present in more severe cases
=====Inhalation Anthrax=====
* [[Bradypnea]] is often present
===Skin===
===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
* [[Edema]] may be present, particularly in the [[neck]] region
* [[Pallor]] may be present in cases of systemic anthrax with [[shock]]
* [[Pallor]] may be present in cases of systemic anthrax with [[shock]]
=====Inhalation Anthrax=====
* [[Cyanosis]] may be present
* [[Pallor]] may be present
===Throat===
===Throat===
* The [[throat]] may be [[erythematous]] if the lesion is located on the [[oropharyngeal]] mucosa
=====Gastrointestinal Anthrax=====
* [[Exudate]] may be present if the lesion is located on oropharyngeal mucosa
* The [[throat]] may be [[erythematous]] if lesion located on [[oropharyngeal]] mucosa
* Tonsillar [[inflammation]] may be present if the lesion is 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
=====Inhalation Anthrax=====
* [[Edema]] may be present
 
===Neck===
===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
* Painful [[lymph nodes]] may be present
* [[Edema]] may be present in [[oropharyngeal]] anthrax
* [[Edema]] may be present in [[oropharyngeal]] anthrax
=====Inhalation Anthrax=====
* [[Edema]] may be present
* [[Lymph nodes]] may be present
===Auscultation===
=====Inhalation Anthrax=====
* [[Heart]] and [[lung]] sounds may be decreased in the presence of [[pleural effusion]]
===Abdomen===
===Abdomen===
=====Cutaneous Anthrax=====
*[[Abdominal tenderness]] may be present, particularly if exuberant vomiting
=====Gastrointestinal Anthrax=====
* [[Abdominal distention]] may be present
* [[Abdominal distention]] may be present
* [[Abdominal tenderness]] may be present
* [[Abdominal tenderness]] may be present


===Extremities===
===Extremities===
=====Cutaneous Anthrax=====
*[[Edema]] may be present, particularly around the initial lesion
=====Gastrointestinal Anthrax=====
* [[Edema]] may be present
* [[Edema]] may be present
===Neurologic===
=====Inhalation Anthrax=====
* The [[mental status]] may be altered in case of severe systemic anthrax
* [[Coma]] may be present
 
==Inhalation Anthrax==
===Vitals===
====Temperature====
* A [[fever]] is often present
* [[Tachycardia]] is often present
====Blood Pressure====
* [[Hypotension]] may be present in severe systemic cases
====Respiratory Rate====
* [[Bradypnea]] may be present in more severe cases
===Skin===
* [[Cyanosis]] may be present
* [[Cyanosis]] may be present
===Neck===
* [[Edema]] may be present
* [[Edema]] may be present
* [[Lymph nodes]] may be present


===Auscultation===
* [[Heart]] and [[lung]] sounds may be decreased in the presence of [[pleural effusion]]
===Extremities===
* [[Cyanosis]] may be present
* [[Edema]] may be present
===Neurologic===
===Neurologic===
* The [[mental status]] may be altered in case of severe systemic anthrax
=====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
=====Inhalation Anthrax=====
* [[Mental status]] may be altered in case of severe systemic anthrax
* [[Coma]] may be present
* [[Coma]] may be present
==Injection Anthrax==
===Vitals===
====Temperature====
* A [[fever]] is often present
====Respiratory Rate====
* [[Tachycardia]] is often present


==References==
==References==

Revision as of 19:55, 17 July 2014

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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]

Overview

The physical findings of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection). Common findings associated with cutaneous anthrax infection include fever, tachycardia, skin rash with formation of a typical scar, edema and lymphadenopathy; with gastrointestinal anthrax infection include fever, tachycardia, mucosal ulcer and edema in case of oropharyngeal lesion and edema and pallor in more severe cases; with inhalation anthrax infection includes: fever, tachycardia, bradypnea in severe cases, pallor, cyanosis and decreased heart and lung sounds in the presence of pleural effusion; and with anthrax infection due to injection include fever, typical skin scar at the site of injection, edema and subcutaneous and/or muscular abscess.

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.[1][2]

Vitals

Temperature

Cutaneous Anthrax
Gastrointestinal Anthrax
Inhalation Anthrax
Injection Anthrax

Pulse

Rate
Cutaneous Anthrax
Gastrointestinal Anthrax
Inhalation or Pulmonary Anthrax
Injection Anthrax

Blood Pressure

Cutaneous Anthrax
Gastrointestinal Anthrax
Inhalation Anthrax

Respiratory Rate

Gastrointestinal Anthrax
  • Bradypnea may be present in more severe cases
Inhalation Anthrax

Skin

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

Throat

Gastrointestinal Anthrax
Inhalation Anthrax

Neck

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

Auscultation

Inhalation Anthrax

Abdomen

Cutaneous Anthrax
Gastrointestinal Anthrax

Extremities

Cutaneous Anthrax
  • Edema may be present, particularly around the initial lesion
Gastrointestinal Anthrax
Inhalation Anthrax

Neurologic

Cutaneous Anthrax
Gastrointestinal Anthrax
Inhalation Anthrax

References

  1. ↑ "Anthrax symptoms".
  2. ↑ "Anthrax in Humans and Animals" (PDF).
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