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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