cutaneous anthrax

University Erlangen
Department of Dermatology
phone (+49)9131-85-2727

cutaneous anthrax


photo: Robert Aylesworth

Under the microscopeone one sees innumerable long, threadlike chains, consisting of bacilli, "Medusa Head"
painted by Garavaggio

Medusa was beheaded by the hero Perseus, who thereafter used her head as a weapon untill he gaved it to the godess Athena to place on her shield

A letter sent to Senate Majority Leader Tom Daschle containing anthrax powder killed two postal workers

Osama Bin Laden used anthrax

photo: Jason Burke

IIME Magazine Cover, Oct.22,2001

Anthrax letters.

FBI warnings.

Bin Laden's videotapes.

Bombarded by threats real and imagined, a nation on edge asks,

What's next?

Bacillus anthracis

  • General information

    • the following information is not yet verified
      Family: Bacillaceae

      Bacillus cereus group: B. anthracis, B. cereus, B. mycoides, B. thuringiensis

      Natural habitats
      Soil inhabitant in sporulated form. Anthrax spores in soil can remain infectious for decades.

      They are obligate pathogens.

      Isolated from blood of animals and human with anthrax, animal carcasses and products and soil contaminated with spores

      Clinical significance / ANTHRAX

      - cutaneous anthrax
      Infection occurs through a break in the skin. Following the incubation period of usually 2 to 3 days, a small papule appears, progressing over the next 24h to a ring of vesicles, with subsequent ulceration and formation of a characteristic blackened eschar.
      Subsequent eschar formation may become thick and surrounded by extensive edema.
      Fever and pus and pain at the side are normally absent; their presence probably indicate a secondary bacterial infection.

      - gastrointestinal anthrax
      The symptoms are the result of ulcerations developing primarily in the cecal and terminal ileal mucosae: vomiting, nausea and abdominal pain, accompanied by fever.

      This can rapidly progress to bloody diarrhea and systemic infection

      - inhalation anthrax / bioterrorism
      The inhaled spores are ingested by macrophages and carried from the lungs to the lymphatic system, where the infection progresses.
      During transit to lymph nodes, spores germinate into vegetative cells, begin to replicate and produce the capsule and toxins that lead to bacteremia and associated hemorrhage and necrosis.

      Anthrax is high on the list of agents that could be used in biological warfare or bioterrorism.

  • Diseases

  • Gram stain

    • the following information is not yet verified
      Gram positive rods

      1.0-1.3 x 3.0-6.0 µm

      (only B.cereus group + B.megaterium >1 µm)

      The bacilli tend to occur in chains (appearance of bamboo)

      Spore shape: ellipsoidal
      Spore position: central of paracentral
      Sporangia swelling: negative

      Capsule present
      Capsule is produced ‘in vivo’ or in blood containing medium, the capsule can be visualized by staining smears India ink

  • Culture characteristics

    • the following information is not yet verified

      Facultative anaerobic

      BA: colonies on agar are large, 6-7 mm diameter, matte, opaque, with a "winding" edge, non-hemolytic or weak hemolytic, non-pigmented.

      Under the microscope one sees innumerable long, threadlike chains, consisting of bacilli, "Medusa Head"

      Colonies of the capsulate strains appear mucoid

      Avirulent strains have no capsule

      BBAØ: growth

  • Characteristics

  • References

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