Diagnosis of cutaneous anthrax in resource-poor settings in West Arsi Province, Ethiopia

Abstract

Introduction Cutaneous anthrax is a zoonotic disease caused by the spore-forming bacterium Bacillus anthracis, which typically presents with ulcers after contact with animals or animal products, and is rarely seen in high-income countries but is common in those with low- and middle-incomes. Objective. The aim of this study is to show the main clinical characteristics of cutaneous anthrax in endemic areas. Material and methods The study describes the main clinical characteristics of cutaneous anthrax in eight patients (six female and two male, age range 1 – 56 years) admitted to the rural General Hospital of Gambo, West Arsi Province of Ethiopia from 2010–2013. Results In all cases, lesions began as an erythematous papule located on exposed sites (n=7 head; n=1 thigh) and subsequently became a necrotic black eschar surrounded by an edematous halo. Two patients presented with painful ipsilateral adenopathy near the black eschar. Four patients developed a malignant pustule on the suborbital region of the face. Patients responded positively to treatment, and the lesions resolved, leaving eschars. However, one patient suffered the loss of an eyeball, and another died 12 hours after starting treatment. Conclusions Physicians working in rural areas of resource-poor settings should be trained in the clinical identification of cutaneous anthrax. Early antibiotic treatment is essential for decreasing morbidity and mortality.

Keywords

• Bacillus anthracis
• cutaneous anthrax
• Ethiopia