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. 2002 Jul;8(7):649-51.
doi: 10.3201/eid0807.020062.

Anthrax of the gastrointestinal tract

Thira Sirisanthana  1 , Arthur E Brown
Affiliations

Anthrax of the gastrointestinal tract

Thira Sirisanthana et al. Emerg Infect Dis. 2002 Jul.

Abstract

When swallowed, anthrax spores may cause lesions from the oral cavity to the cecum. Gastrointestinal anthrax is greatly underreported in rural disease-endemic areas of the world. The apparent paucity of this form of anthrax reflects the lack of facilities able to make the diagnosis in these areas. The spectrum of disease, ranging from subclinical infection to death, has not been fully recognized. In some community-based studies, cases of gastrointestinal anthrax outnumbered those of cutaneous anthrax. The oropharyngeal variant, in particular, is unfamiliar to most physicians. The clinical features of oropharyngeal anthrax include fever and toxemia, inflammatory lesion(s) in the oral cavity or oropharynx, enlargement of cervical lymph nodes associated with edema of the soft tissue of the cervical area, and a high case-fatality rate. Awareness of gastrointestinal anthrax in a differential diagnosis remains important in anthrax-endemic areas but now also in settings of possible bioterrorism.

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Figures

Figure 1
Figure 1
A 29-year-old man, 1 day after the onset of symptoms of oropharyngeal anthrax. Marked and painful swelling of the right side of the neck was present.
Figure 2
Figure 2
A 27-year-old man, 5 days after the onset of symptoms of oropharyngeal anthrax. Edema and congestion of the right tonsil extending to the anterior and posterior pillars of fauces as well as the soft palate and uvula were present. A white patch had begun to appear at the center of the lesion.
Figure 3
Figure 3
The same patient as in Figure 2. This picture is 9 days after the onset of symptoms of oropharyngeal anthrax. The white patch had developed into a pseudomembrane covering the lesion.
See this image and copyright information in PMC

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