Palpebral anthrax, a rare though important condition in villagers: A case report and literature review

Abstract

The aerobic Gram-positive rod Bacillus anthracis can cause potentially lethal diseases affecting different organs. Localized eyelid inflammation is a rare presentation of cutaneous anthrax. This case report involves two patients with palpebral anthrax admitted to the oculoplastic ward of Feiz Eye Hospital, Isfahan, Iran. The patients had a history of close contact with animals. Clinical presentation included palpebral swelling and necrosis of the eyelids in both cases. The patients first underwent an appropriate antibiotic regimen, and biopsy specimens were collected from their necrotic tissues. They were discharged after complete healing and followed up to manage possible complications. Cicatricial ectropion developed in both cases during healing. Reconstructive surgery was scheduled for both cases 6 months after their discharge.

Cutaneous Anthrax on the Upper Eyelid

“…It has been suggested that bacterial culture results may turn negative 3–4 h after the use of systemic antibiotics. For differential diagnosis, furuncles, carbuncles, erysipelas, necrotizing cellulitis, and other necrotizing infective ulcers should be evaluated, and bacterial culture should be taken before starting antibiotic therapy [6, 8]. In our case, anthrax was detected in the wound culture of the lesion, and clinical findings confirmed the diagnosis of periocular anthrax.…”

A Case Report of Cutaneous Anthrax Diagnosed by Using a Metagenomic Next-Generation Sequencing (mNGS) Approach

“…Previously published anthrax case reports mostly relied on culture and smear for diagnosis. 1 , 10–12 Here, we reported the first case of cutaneous anthrax diagnosed by mNGS. On the basis of the clinical features of this patient’s skin lesions, we considered the possibility of cutaneous anthrax.…”

A Rare Presentation of Anthrax: A Pediatric Patient with Palpebral Anthrax

“…It has been reported that the prevalence of complications decreases with early diagnosis and appropriate antibiotic treatment. [2,3] Anthrax is a rare zoonotic disease in humans caused by Bacillus anthracis. The most common form of this disease is cutaneous anthrax.…”

“…[ 1 ] Cutaneous anthrax is most commonly seen in the head, neck, and upper extremities, and although palpebral involvement is rare, it has an important place in eyelid complications. [ 2 ] Palpebral anthrax accounts for only 4% of anthrax cases. In cases of palpebral anthrax, complications such as cicatricial ectropion, eschar formation, and lagophthalmia may develop despite treatment.…”

“…It has been reported that the prevalence of complications decreases with early diagnosis and appropriate antibiotic treatment. [ 2 , 3 ]…”