infectious diseases

Symptoms Anthrax

Related articles: Anthrax

Definition

Anthrax is an infectious disease caused by Bacillus anthracis, an optional aerobic or anaerobic organism, capsulated and toxin producer.

Infection is often lethal in farm animals (such as goats, cattle, sheep and horses) and wild animals (eg elephants and buffaloes). For humans, anthrax is typically transmitted through the skin following contact with infected animals or their products (eg leather). Open wounds or abrasions increase predisposition, but infection can occur even when the skin is intact. Cutaneous anthrax can be transmitted from person to person, through direct contact or following exposure to contaminated material.

Human infection can also be contracted through the ingestion of inadequately cooked meat, containing the vegetative forms of the microorganism, and the inhalation of spores, almost always due to occupational exposure to contaminated products of animal origin. The groups at risk include farmers, veterinarians, butchers, tanners and carders. Inhalation anthrax and gastrointestinal infection are not transmitted from person to person.

Under aerobic conditions, Bacillus anthracis is able to produce extremely resistant spores, which can remain viable in the soil, wool and animal hair for decades. Spores germinate and multiply rapidly when they enter an environment rich in amino acids and glucose (such as tissues and blood).

Fortunately, natural infection is quite rare in industrialized areas, but the potential use of anthrax as a biological weapon has increased the fear of this disease. In the United States, in 2001, the spores of the microorganism were used as bioterrorism weapons and widespread, in the form of very fine dust, through the postal service.

Most common symptoms and signs *

  • Ascites
  • Asthenia
  • Bacteremia
  • Cyanosis
  • Diarrhea
  • Dysphagia
  • Dyspnoea
  • Abdominal pain
  • Neck pain
  • Chest pain
  • Articolar pains
  • Muscle pains
  • Edema
  • Gastrointestinal hemorrhage
  • hemothorax
  • Erythema
  • eschar
  • Temperature
  • Hypotension
  • lymphadenitis
  • Swollen lymph nodes
  • Sore throat
  • Headache
  • Mass or swelling in the neck
  • Meningitis
  • Nausea
  • Multiple pulmonary nodules
  • papules
  • pneumothorax
  • itch
  • Hoarseness
  • Stiffness in the muscles of the back and neck
  • Blood in the stool
  • Confusional state
  • Cough
  • Skin Ulcers
  • Pleural effusion
  • He retched

Further indications

Anthrax is characterized by numerous symptoms that differ depending on the mode of transmission and on the pathway of pathogens or spores. Generally, three forms of disease are described: cutaneous, pulmonary and gastrointestinal anthrax.

Most patients who contract the infection show the first symptoms within 1-6 days of exposure, but due to the inhalation form of the anthrax, the incubation period can be longer than 6 weeks.

In respiratory and gastro-intestinal infections, non-specific local symptoms are typically followed within a few days by a severe systemic illness and, often, by death. Bacteremia can occur in all forms of anthrax and occurs in almost all fatal cases.

Cutaneous anthrax

Cutaneous anthrax begins 1-10 days after exposure to the pathogen with a red-brown papule, painless and itchy at the point of inoculation. This lesion progressively increases in size and rapidly turns into a vesicle, which has a surrounding area of ​​erythema and marked edema. This is followed by an ulceration, with serum-bloody exudate and formation of a black eschar (carbuncle). After 2-3 weeks, the crust resulting from the necrotic pustule comes off and falls, leaving a scar.

Cutaneous anthrax frequently causes local lymphadenopathy, sometimes with general malaise, myalgia, low blood pressure, headache, high fever, nausea and vomiting.

If left untreated, the infection can develop into severe septicemia with lethal consequences; applying the appropriate therapy, on the other hand, death can be avoided in practically all cases.

Gastrointestinal anthrax

In this type of anthrax, the bacterial infection of the upper digestive tract (oropharyngeal region) differs from that of the gastrointestinal tract.

Oropharyngeal anthrax manifests as oedematous lesions with necrotic ulcers on the tonsils, on the posterior wall of the pharynx or on the hard palate. This makes swallowing difficult and causes dyspnea, hoarseness, sore throat and fever. The swelling of the soft tissues of the neck is marked and the cervical lymph nodes increase in size. Airway obstruction can occur.

Gastrointestinal anthrax has a variable course, ranging from asymptomatic to fatal forms.

The toxin released by Bacillus anthracis in the digestive tract causes necrotic-hemorrhagic ulcers and mesenteric lymphadenitis, which can lead to intestinal bleeding, obstruction or perforation.

Frequent symptoms include fever, nausea, vomiting, severe abdominal pain, bloody diarrhea and sometimes ascites. Intestinal necrosis and septicemia may follow, with potentially lethal toxicity.

Inhalation anthrax

Inhalation of a very fine powder containing pathogens or droplets causes an often fatal lung infection. Pulmonary anthrax occurs insidiously, with non-specific flu-like symptoms, including high fever, chest pain, headache, arthralgia, cough and feeling sick. Within a few days, cyanosis, sternum pain, difficulty breathing, shock and coma appear. In respiratory infection there is also a severe hemorrhagic-necrotizing lymphadenitis that extends to adjacent mediastinal structures. Serum-bloody transudate, pulmonary edema and blood pleural effusion appear. Furthermore, haemorrhagic meningo-encephalitis and / or gastrointestinal anthrax may occur. Severe respiratory distress and septicemia can cause cardiocirculatory arrest and death in a short time.

By applying the appropriate therapy, the mortality rate for patients can be reduced, while remaining high (up to 80%).

Diagnosis and treatment

The diagnosis of anthrax includes medical history, cultures and Gram staining of samples taken from cutaneous or mucosal lesions, pleural fluid, CSF, ascitic fluid or faeces. Furthermore, if pulmonary symptoms are present, a chest X-ray or computer tomography should be performed. When patients present with meningeal signs or an alteration in mental status, a rachicentesis should be performed instead.

Empirical therapy is based on ciprofloxacin or doxycycline. A vaccine is available for high-risk individuals.