A Case of Fatal Gastrointestinal Anthrax in North Eastern Iran

Abstract

Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient with intestinal anthrax. Bacillus anthracis was isolated from a blood culture of a 34-year-old man who had a history of severe abdominal pain, bloody diarrhea, nausea, vomiting, fever, sweating, and lethargy within 4 to 5 days after eating the meat of domestic goat. He had evidence of severe infection and septic shock and did not respond to treatments and subsequently expired 9 hours after hospitalization. Conclusion. Gastrointestinal anthrax is characterized by rapid onset, fever, and septicemia. Rapid diagnosis and prompt initiation of antibiotic therapy can help in survival. Most of previous cases of septicemic anthrax were related to injection drug users but, in our case, septicemia occurred after gastrointestinal anthrax.

Outbreak of gastrointestinal anthrax following eating beef of suspicious origin: Isingiro District, Uganda, 2017

“…Assuming the illness was gastrointestinal anthrax with a median incubation period of 3 days and a range from 1 to 6 days [3,12], we calculated the period of likely exposure to be from 17-18 August. Although cutaneous anthrax is known to commonly occur along with the gastrointestinal anthrax, we did not identify any case-patients with signs of cutaneous anthrax.…”

“…Anthrax is a zoonotic bacterial disease that occurs worldwide, with an estimated 2,000 to 20,000 human anthrax cases occurring each year [1]. The causative agent of anthrax, Bacillus anthracis, is a large, gram-positive, aerobic, spore-forming bacillus [2,3]. The infectious form of B. anthracis is usually the spores, which can remain viable in the environment for an extended period of time [1,4,5] even under extreme environmental conditions [6].…”

“…Human anthrax infections are classified into cutaneous, gastrointestinal, and inhalational disease, depending on the clinical features and transmission routes [3,7]. Human gastrointestinal anthrax occurs after ingesting meat and other products from infected animals [3,6,7,8,9]. The incubation period ranges from 1-6 days, with a median of 3 days [3,10,11,12].…”

“…Human gastrointestinal anthrax occurs after ingesting meat and other products from infected animals [3,6,7,8,9]. The incubation period ranges from 1-6 days, with a median of 3 days [3,10,11,12]. Patients commonly present with fever, malaise, abdominal pain and tenderness, diarrhoea, nausea, vomiting, and abdominal distention.…”

“…Patients commonly present with fever, malaise, abdominal pain and tenderness, diarrhoea, nausea, vomiting, and abdominal distention. In severe cases, there may be hemorrhage (commonly manifesting as bloody diarrhoea), intestinal obstruction or perforation, ascites, sepsis, or shock [2,3,6,10,11]. Gastrointestinal anthrax can be confirmed by positive culture from vomitus, stool, blood, peritoneal or tissue samples, or by positive serology [3].…”