Cutaneous Anthrax Infection

Abstract

A seven-month-old male infant was hospitalized with a two-day history of swelling of the left arm and a weeping lesion at the left elbow (Panel A). The patient was afebrile but had a 2-cm open sore, with surrounding erythema and induration, that oozed clear yellow fluid. There was nontender swelling and erythema of the entire arm. The white-cell count was 28,100 per cubic millimeter. Incision and drainage of the lesion produced 10 ml of dark red fluid. A coronal, T 1 -weighted sequence from a magnetic resonance imaging study (Panel B) demonstrated diffuse, severe edema of the subcutaneous tissues extending from the shoulder to the hand. The working diagnosis was Loxosceles reclusa spider bite with superimposed cellulitis. The child was treated with ampicillin-sulbactam and clindamycin. He had been at his mother's office at a television network three days before admission, two weeks after the destruction of the World Trade Center in New York. After anthrax exposure was reported at another television network, two punch biopsies of the lesion were performed. Polymerase chain reaction and immunostaining for Bacillus anthracis were positive. The patient was discharged in stable condition.

Tissue loss (white syndrome) in the coral Montipora capitata is a dynamic disease with multiple host responses and potential causes

“…Malaria would be an example of a systemic disease [50], whereas cutaneous anthrax [51] would be a localized disease. Corals do not have organs per se, but a similar analogy applies in that infectious agents can be disseminated throughout the colony or restricted to the lesion.…”

Arthropods in dermatology

“…There are reports of both a chemical burn and a cutaneous anthrax infection being mistaken for bites of the brown recluse spider. 75,76 This potential for misdiagnosis has led to the development of a sensitive enzyme-linked immunosorbent assay for Loxosceles species venom that may eventually have useful clinical applications. 77 The brown recluse is a nonaggressive spider and will seek out shelter in undisturbed places, such as attics, closets, and storage areas for bedding and clothing.…”

Reports of Envenomation by Brown Recluse Spiders (Araneae: Sicariidae) Outnumber Verifications ofLoxoscelesSpiders in Florida

“…This has lead to many instances of erroneous attribution of necrotic lesions to spiders (Kemp 1990, Moaven et al 1999, Roche et al 2001, Osterhoudt et al 2002, Vetter and Bush 2002b, Isbister and Whyte 2004 due in part to arachnophobia as well as the need of patients and physicians to attribute an easily recognizable, external cause to idiopathic ulcers (Isbister 2004). Physicians should diagnose idiopathic necrotic ulcer when the etiology is uncertain.…”