Cutaneous Anthrax Disease

The incubation period of anthrax is from 2 to 5 days. Anthrax bacillus is the causative organism. The sources of infection are: wool, hides, infected animals and shaving brushes.

For these reasons, wool sorters, hide porters and butchers are often affected. The commonest clinical feature is a malignant pustule. It starts as an itchy, red spot which looks like an insect bite. Soon a vesicle is formed which dries to form a reddish black slough.

Typically, a malignant pustule consists of a central slough with surrounding induration, with or without vesicles. Further towards the periphery, there is oedema and redness. If the disease is not controlled at this stage, fulminating septicaemia with intestinal and pulmonary symptoms develop.

The common sites are the hands, shoulders and face depending upon the source of infection. Anthrax oedema and erysipelas are uncommon; they are caused by deeper inoculation by the causative organisms.

Bacillus anthracis can be demonstrated infrequently in cutaneous anthrax. The diagnosis should be made on clinical grounds. The prognosis is good in the early stages when the disease is localized. Once dissemination occurs, the outlook becomes grave, and the mortality rate becomes high.

Treatment of Cutaneous Anthrax

1. Scalvo's anti-anthrax serum. 100 units immediately (intramuscularly), and 60 units daily, till the disease disappears.

2. Crystalline penicillin injections intra-muscularly, 4 lacs four times a day, till the pustule subsides. Broad-spectrum antibiotics are also useful.

3. Local dressing with bacitracin ointment.

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