A sweaty summertime letter carrier proceeds through his route delivering mail. On his way back to the post office he notices a white powder on his shorts. Confused as to whether this is the generous sprinkling of Gold Bond he used earlier to ensure his dryness or something more sinister, he begins to panic. Describe the signs and symptoms of the three forms of this potentially deadly spore-forming rod.Answer
Cutaneous anthrax presents as papules that rapidly progress to vesicles. After 1 week, the vesicles rupture forming eschar underneath. This is associated with soft tissue edema, lymphadenopathy and constitutional symptoms. Pharyngeal or Gastrointestinal anthrax presents as pharyngeal edema and abdominal pain followed by upper and lower GI bleeding. Inhalational anthrax, the most deadly form, begins as flu-like symptoms and progresses to respiratory failure and septic shock. A CXR or chest CT shows a widened mediastinum, with significant mediastinal lymphadenopathy. The mainstay of treatment for all forms of anthrax is supportive care and antibiotics.  Treatment is with 60 days of doxycycline for the most benign cases of cutaneous anthrax. If the patient has inhalational anthrax or has sepsis from cutaneous or GI anthrax antibiotic treatment includes ciprofloxacin OR doxycycline, PLUS 2 other antibiotics (clindamycin, rifampin). For. 60. Days.
Source: Rivers. Word.
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