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ANTRAKSwoolsorter’s disease, siberian ulcer,
ragsorter’s disease
Risna
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ETIOLOGI
Bacillus anthracis yang merupakan basilgram positif, non-motil dan bisa membentuk
spora (sporulasi)
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Clinical findings Symptoms and signs 1. Cutaneous anthrax
. !nhalational anthrax bioterrorism
". #astrointestinal anthrax
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C$%&'$S &'%&*S
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1. Cutaneous anthrax !ncubation period +eeks
%he initial lesion is an erythematous papule, often on an
exposed area of skin that esiculated and then ulcerated
and undergoes necrosis, ultimately progressing to a
purple to black schar
ainless pain indicates secondary infection
%he surrounding area is edematous and esicular but
not purulent
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Clinical findings Cutaneous anthrax (cont.)
egional adenopathy, /
0eer
alaise
2eadache
'ausea and omiting
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2. Inhalational anthrax
%+o stages
Begins on aerage 13 days after exposure. <hough a
longer incubation period of up to 4 +eeks
'onspecific iral-like symptoms
0eer
alaise
2eadache
5yspnea
Cough
Congestion of the nose, throat
and larynx
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2. Inhalational anthrax (cont.)
%+o stages
&nterior chest pain is an early symptom of
mediastinitis. 6hithin hours to a fe+ days, progression
to the fulminant stage of infection occurs in +hich signs
and symptoms of sepsis predominate
5elirium, obtudation, or meningeal irritation suggest an
accopanying hemorrhagic meningitis". #astrointestinal anthrax /
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!'2&7&%!8' &'%&*S
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3. Gastrointestinal anthrax
Symptoms begin -9 days after ingestion of meatcontaminated +ith anthrax spores
0eer
5iffuse abdominal pain
ebound abdominal tenderness
:omiting
Constipation or diarrhea
mesis is blood-tinged or coffee-ground%he stool may be blood tinged or melenic
Bo+el perforation
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#&S%8!'%S%!'&7 &'%&*S
&. Suatu edema berat padalengkungan duodenum padaintestinal anthrax dengan suatupembesaran limfonodus ( diantara ;ari dokter bedah di atas ).
B. Segmen usus yang samasetelah dibuka. %erdapat edema,nekrosis, dan mukosa hemoragik.Sebuah eschar sentral ( padatanda panah ) dan tersisa nodulkecil yang mengelilingi pada lesicutaneus anthrax
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Clinical findings 4. The oropharyngeal form of the
disease is characterized y!
7ocal lymphadenopathy
Cerical edema
5ysphagia
$pper respiratory tract obstruction
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5ifferential diagnosis
%ypes of anthrax 55
-Cutaneous anthrax -Ecthyma gangrenosum, rat bite fever,ulceroglandular tularemia, plague,glanders, rickettsialpox, orf, cutaneous
mycobacterial infection
-Inhalational anthrax -mediastinitis
-Gastrointestinal anthrax -Boel obtruction, perforatesviscus,peritonitis, gastroenteritis, pepticulcer disease
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%reatment &ntimicrobial agents ecommended dosee
0irst-line agents - !iprofloxacin, " x #$$ mg daily orally or " x %$$ mg&'" hours intravenously (I)* +O!
- +ocycycline, '$$ mg every '" hours orally or I)
Second-line agents - moxicillin - x #$$ mg daily orally
- .enicillin G, " m/ every % hours intravenously
<ernatie agents+ith in itro actiity
- 0ifampin, '$ mg&kg&d orally or intravenously
- !lindamycin, %#$12$$ mg every 3 hours orally&iv
- !larithromycin, #$$ mg tice daily
- Erythromycin, #$$ mg mg every 2 hours iv
- )ancomycin, ' g every '" hours
- Imipenem, #$$ mg every 2 hours iv
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8#'8S!S
!nhalation anthrax