infections
Anthrax
Symptoms of Anthrax
Anthrax symptoms vary depending on how the infection is acquired: Through the skin (most cases) Through inhalation (most serious) Through the gastrointestinal tract (rare) Through injection (rare) Most anthrax cases involve the skin. A painless, itchy, red-brown bump appears 1 to 10 days after exposure. The bump forms a blister, which eventually breaks open and forms a black scab (eschar), with swelling around it. Nearby lymph nodes may swell, and people may feel ill—sometimes with muscle aches, headache, fever, nausea, and vomiting. It may take several weeks for the bump to heal and the swelling to go down. About 10 to 20% of untreated people die, but with treatment, death is rare. Inhalation anthrax is the most serious. It results from inhaling anthrax spores, almost always when people are working with contaminated animal products (such as hides). Spores may stay in the lungs for weeks but eventually enter white blood cells called macrophages, where they germinate, and the resulting bacteria multiply and spread to lymph nodes in the chest. The bacteria produce toxins that make the lymph nodes swell, break down, and bleed, spreading the infection to nearby structures. Infected fluid accumulates in the space between the lungs and the chest wall. Symptoms develop 1 day to 6 weeks after exposure. Initially, they are vague and similar to those of influenza (flu), with mild muscle aches, a low fever, chest discomfort, and a dry cough. After a few days, breathing suddenly becomes very difficult, and people have chest pain and a high fever with sweating. Blood pressure rapidly becomes dangerously low (causing Shock ), followed by coma. These severe symptoms probably result from a massive release of toxins. Gastrointestinal anthrax or an infection of the brain and the tissues covering the brain and spinal cord (meninges)—an infection called meningoencephalitis—may develop. Many people die 24 to 36 hours after severe symptoms start, even with early treatment. Without treatment, all people with inhalation anthrax die. In the 2001 outbreak in the United States, 45% of people treated for inhalation anthrax died. Gastrointestinal anthrax is rare. When people eat contaminated meat, the bacteria grow in the mouth, throat, or intestine and release toxins that cause extensive bleeding and tissue death. People have a fever, a sore throat, a swollen neck, abdominal pain, and bloody diarrhea. They also vomit blood. Even with treatment, about 40% of infected people die, probably because they have already become very ill before the diagnosis is made. Anthrax spores are not easily killed by cold or heat and can survive for decades. Over 1.25 million people have received the anthrax vaccine without having a serious adverse reaction. Injection anthrax is rare. Symptoms may be similar to those of Skin anthrax (cutaneous anthrax) , such as fever and an itchy bump or bumps that appear where the heroin was injected. The bump develops into a painless sore that forms a black scab (eschar) with swelling around it. A pocket of pus (abscess) may develop deep under the skin or in the muscle where the heroin was injected. Injection anthrax can spread throughout the body faster than skin anthrax and can be harder for doctors to diagnose and treat than skin anthrax. 