Hemorrhagic Mediastinitis, Often Without Pneumonia, and hemorrhagic meningitis
Microbial Diseases On Hemorrhagic Mediastinitis, Often Without Pneumonia, and hemorrhagic meningitis may occur. Death is common in this form of anthrax; the illness may begin abruptly, be of short duration, and terminate rapidly. Dyspnea and cyanosis are Indicative of respiratory or ventilatory in-sufficiency. Leukocytosis is ordinarily not pronounced. Pleural effusion may complicate pulmonary anthrax. Anthrax in man from ingestion of bacilli is rare. Diagnosis. Cutaneous anthrax can be differentiated from many other bacterial, infections of the skin by the insignificance of regional adenopathy.
1. lymphangitis, and cellulitis in relation to the severity of the eschar and edema. Small skin lesions, however, may be more difficult. To recognize. Occasionally, the bacilli may be identified in the centrifugal sediment of blood treated with 3 percent acetic acid solution and stained with wright's stain. In cutaneous anthrax, the bacilli can usually be cultured from the lesions, or typically encapsulated bacilli will be seen when stained with polychrome eosin–methylene blue stain (wright or Giemsa). Their direct cultivation on peptone agar should always be attempted. If the in view figure.
2. Same patient 72 hours after the start of oxytetracycline therapy. Note virtually complete disappearance of edema. B. Anthracis is no longer demonstrable in stained smears of exudate. (courtesy of Drs. Vernon knight and a. Ruiz Sanchez.) cutaneous anthrax is often a self-limited disease, but the dissemination of the infection and death may occur in 20 percent of patients. A fatal outcome in cutaneous anthrax can be averted by appropriate treatment, but the treatment of disseminated infection is often unsuccessful in preventing death.
Treatment. B. Anthracis is susceptible to the action of penicillin and tetracyclines. (1 and 2) maybe administered in a total daily dose of 2.0 grams. Therapy with penicillin or tetracyclines should be continued for seven days. vaccination with “protective' antigen” is effective in preventing infection in persons likely to be occupationally exposed.
Brachman, p. S. human anthrax in the united states. In the hobby, g. L. (ed.): antimicrobial agents and chemotherapy. Figure
1. Cutaneous anthrax with facial and orbital edema Baltimore, Williams, and Wilkins company, 1965. Immediately preceding oxytetracycline therapy. Innumerable brahman, p. S., Plotkin, s. A., Rumford, f. H., and Atchison, b. Anthracis are visible on a stained smear of material from the lesion. M. M.: An epidemic of inhalation anthrax. Ii. Epidemiologic courtesy of Drs. Vernon knight and a. Ruiz Sanchez.) investigation. Amer. J. Hyg., 72:6, 1960.