Free shipping and hand lesions

By Lauren Brock

T. Brokaw, a 74 year old sheep and cattle farmer.

Went to see his physician when what he believed to be a spider bite on his hand became larger and developed into a black ulcer.

Wound samples were taken and cultured. Results showed a gram positive bacillus Grew well on all usual media except CNA or

PEA Gamma-hemolytic on SBA Catalase Postive

Patient History

http://textbookofbacteriology.net/Anthrax.html

http://clinicalsciences.wordpress.com/article/raxibacumab-abthrax-hgs-review-3fy5eowy8suq3-85/

http://randstarteam.blogspot.com/2007/12/mmic-pbl-1_10.html

Bacillus anthracis!!

https://bandlogos.wordpress.com/tag/anthrax-logo/

Aerobic Non-motile Catalase Positive Large gram-positive Endospore Medusa-Head, gamma-hemolytic on SBA Recovered from blood, wound, CSF, or

lymph nodes

Presumptive ID

Must be reported◦ LRN, Laboratory Response Network

Can measure antibodies or toxins in the blood◦ ELISA◦ Evidence of four-fold rise in antibodies to

protective antigen

Confirmative ID

Most often seen with cows, sheep, and goats.◦ “Wool-sorter’s

Spores in the soil 3 types

◦ Cutaneous◦ Pulmonary◦ Gastrointestinal

Severity and death usually due to fulminant septicemia

Clinical Significance

Image warning!

Cutaneous ◦ Most common, though still rare in the US◦ 1-7 days after exposure◦ 20% of patients die without treatment◦ Injection-associated with heroin users in northern

europe.◦ Black eschar, usually painless

3 types of Anthrax

rmoist01.tripod.comhttp://en.wikipedia.org/wiki/Anthrax

http://bepast.org/dataman.pl?c=flib&dir=docs/photos/anthrax/

Pulmonary(Inhalation)◦ Most deadly◦ “White powder”◦ A week to 2 months after exposure◦ Only 10-15% survive without treatment◦ 55% survive with aggressive treatment

http://en.wikipedia.org/wiki/Anthrax

http://science.howstuffworks.com/anthrax2.htm

http://wmdjunction.com/110822_fbi_anthrax.htm

Gastrointestinal◦ 1-7 days after exposure◦ More than half of patients with this type die

without treatment, 60% survive with it.◦ Was endemic in Lebanon 1960s

http://wwwnc.cdc.gov/eid/article/8/7/02-0062-f3.htm

http://science.howstuffworks.com/anthrax2.htm

http://wwwnc.cdc.gov/eid/article/9/5/02-0537-f2.htm

Polypeptide capsule◦ antiphagocytic

Anthrax toxins◦ Protective antigen

Actually used to make vaccines◦ Edema factor

Edema◦ Lethal factor

Tissue necrosis

Pathogenic Mechanisms

http://arshad-zist.blogfa.com/author-arshad-zist.aspx

Antibiotics such as penicillin, cephalosporin, ciprofloxacin

Antitoxin

AVA, Anthrax Vaccine Absorbed, BioThrax◦ Not for general public, only at risk occupations◦ Does not contain the actual bacteria

Culture filtrates of nonencapsulated V770-NP1-R mutant with adjuvant

◦ Shown to mainly protect against cutaneous and inhalation anthrax

Treatment

Easily found in nature Can be produced in Lab Last for decades in environment Tier 1 agent

◦ Biological agent◦ Toxins◦ Mass casualties

Can be released “quietly”◦ Powders, sprays, food, water

Bioterroism

http://www.cdc.gov/anthrax/bioterrorism/threat.html

http://www.cdc.gov/anthrax/bioterrorism/threat.html

Basics. (2013, August 29). Centers for Disease Control and Prevention. Retrieved April 30, 2014, from http://www.cdc.gov/anthrax/basics/index.html

Bacillus anthracis and anthrax. (n.d.). Bacillus anthracis and anthrax. Retrieved April 30, 2014, from http://textbookofbacteriology.net/Anthrax.html

Guidance on anthrax: frequently asked questions. (n.d.). WHO. Retrieved April 30, 2014, from http://www.who.int/csr/disease/Anthrax/anthraxfaq/en/

Mahon, C. R. (2011). Textbook of diagnostic microbiology (4th ed.). Maryland Heights, Mo.: Saunders/Elsevier.

References