Anthrax is an extremely severe zoonotic disease caused by toxigenic B. anthracis. Herbivores can become infected with this by grazing in pastures that are contaminated with spores. Contact with animals (butchering, skinning, or exposure to hides or wool), and consumption of contaminated meat are the risk factors for infection in humans.
Depending on the site of the infection, the cases display different clinical manifestations – cutaneous anthrax, inhalation anthrax (or wool-sorter’s disease) and gastrointestinal disease.
In dental practice cutaneous anthrax may be observed. Here the spores of bacilli are introduced into the skin. Germination occurs within hours, and vegetative cells produce anthrax toxin. The disease usually develops within 1-7 days after entry.
A red macule emerges at the site of inoculation. The lesion subsequently comes into a papular-vesicular stage that is followed by ulceration with a blackened necrotic eschar or anthrax carbuncle (malignant pustule) surrounded by brawny oedema. This lesion is painless. Regional lymphadenitis is commonly seen in these patients. Eventually, eschar dries, loosens, and separates; spontaneous healing occurs in 80 to 90% of untreated cases. However, in severe cases, bacterial dissemination leads to septicemia with a high mortality rate.
▶Anthrax diagnosis relies on clinical findings and disease epidemiology with a subsequent microbiological confirmation. It includes microscopy of samples taken from primary skin lesions and bacterial isolation.
The patients are hospitalized and treated with antibiotics (fluoroquinolones or beta-lactams) and specific immunoglobulin