Ver el código de «Anthrax»

==Background==
*Gram positive rod, Bacillus anthracis, which is capable of surviving inhospitable condition through the formation of endospores. tough spores
*Incubation period is 10 days with no ability for human to human transmission and therefore, no need for respiratory isolation
*In general there is cutaneous, inhalational, and gastrointesinal anthrax. 
===Inhalational (5%)===
*Biphasic course
====Prodrome Period====
*Early prodromal period often appears as an influenza like illness
*Fever, dry cough, mylagia, malaise
*Transient clinical improvement followed by rapid decline
====Acute phase====
*Severe respiratory distress with symptoms consisting of<ref>[http://emedicine.medscape.com/article/212127-overview Medscape: Anthrax]</ref>:
**Hypoxia, tachypnea, cyanosis
**Severe dyspnea, chest pain
**Shock
**Mediasitinits

===Cutaneous (95%)===
[[File:Cutaneous_anthrax.png|thumb|Cutaneous anthrax]]
*The disease will start as an area of errythema and edema and progress to a vesicle which ruptures forming a central black eschar
*Total course of lesion evolution occurs over 1 week

===Gastrointestinal===
*Over the course of 7 days, nonspecific abdominal pain, nausea and vomitting with progress to severe abdominal pain, bloody emesis and diarrhea (usually bloody)<ref> CDC. Gastrointestinal anthrax after an animal-hide drumming event - New Hampshire and Massachusetts, 2009. MMWR Morb Mortal Wkly Rep. 2010 Jul 23;59(28):872-7. http://www.ncbi.nlm.nih.gov/pubmed/20651643</ref>

==Differential Diagnosis==
===Cutaneous (painless)===
*Ecthyma gangrenosum
*[[Rat-bite fever]] (Streptobacillus monilifomis and Spirillum minus)
*Ulceroglandular [[tularemia]]
*[[Plague]]
*[[Glanders]] (Pseudomonas peudomallei)
*Rickettsialpox (Rickettsia akari)
*Orf (parapox virus)
*[[Staph]] [[lymphadenitis]]
*[[TB]]
*[[Leprosy]]
*[[Buruli ulcer]] (Mycobact ulcerans)

===Inhalational===
*Acute bacterial [[mediastinitis]]
*[[Mycoplasma]]
*[[Legionnaire's]]
*[[Psittacosis]]
*[[Tularemia]]
*[[Q fever]] (Coxiella burnetti)
*Viral pneumonia
*[[Histoplasmosis]]
*[[Coccidiomycosis]]
*Ruptured [[Aortic Dissection]]
*[[SVC syndrome]]
*[[Silicosis]]
*[[Sarcoidosis]]

{{Lower respiratory zoonotic infections}}

{{Bioterrorism agents}}

==Diagnosis==
CXR/CT- Widened mediastinum representing hemorrhagic mediastinitis

==Treatment==
'''Contact CDC Emergency Hotline 1-707-488-7100 for all suspected bioterrorism cases'''

{{Anthrax antibiotics}}

==Disposition==
*Admit

==See Also==
*[[Bioterrorism]]

==References==
<references/>

[[Category:ID]]
[[Category:Tox]]