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Periocular cutaneous anthrax in Jimma Zone, Southwest Ethiopia: a case series.

Gelaw Y, Asaminew T - BMC Res Notes (2013)

Bottom Line: All the three patients responded to intravenous antibiotics, and the lesion resolved leaving scars which caused cicatricial ectropion in all cases.Anthrax is a rare disease but should be considered in the differential diagnosis of ulcerative (and eschar forming) preseptal cellulitis with a history of contact with anthrax-infected animals or animal products.Furthermore, cicatrization of the eyelids, one of the sequelae of periocular cutaneous anthrax, should be addressed.

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Affiliation: Department of Ophthalmology, College of Public Health and Medical Sciences, Jimma University, PO Box: 440, Jimma, Ethiopia. dryeshi@yahoo.com

ABSTRACT

Background: Anthrax is a zoonotic disease caused by Bacillus anthracis. Naturally occurring human infection is rare and is generally the result of contact with anthrax-infected animals or animal products.

Case presentation: We examined three patients who had contact with presumed anthrax-infected animal and/or its product and presented with preseptal cellulitis with a localized itchy erythematous papule of the eyelid and non-pitting periorbital edema, followed by ulceration and dark eschar formation. All the three patients responded to intravenous antibiotics, and the lesion resolved leaving scars which caused cicatricial ectropion in all cases.

Conclusion: Anthrax is a rare disease but should be considered in the differential diagnosis of ulcerative (and eschar forming) preseptal cellulitis with a history of contact with anthrax-infected animals or animal products. Furthermore, cicatrization of the eyelids, one of the sequelae of periocular cutaneous anthrax, should be addressed. Urgent case report to the local zoonotic disease and infection control body and other responsible authorities is recommended.

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Eschar forming lesion.
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Figure 1: Eschar forming lesion.

Mentions: On examination, the patient had diffuse non-pitting edema of both the upper lid and lower lid with ulcerated central dark tissue. It was not tender to touch and there was no abscess (Figure 1). The patient was unable to open the affected lids and it was thus difficult to record visual acuity at presentation but the cornea looked normal. Vital signs were normal and his body temperature was 36.1°C; and the white blood cell (WBC) count was 7, 800 × 103.


Periocular cutaneous anthrax in Jimma Zone, Southwest Ethiopia: a case series.

Gelaw Y, Asaminew T - BMC Res Notes (2013)

Eschar forming lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750427&req=5

Figure 1: Eschar forming lesion.
Mentions: On examination, the patient had diffuse non-pitting edema of both the upper lid and lower lid with ulcerated central dark tissue. It was not tender to touch and there was no abscess (Figure 1). The patient was unable to open the affected lids and it was thus difficult to record visual acuity at presentation but the cornea looked normal. Vital signs were normal and his body temperature was 36.1°C; and the white blood cell (WBC) count was 7, 800 × 103.

Bottom Line: All the three patients responded to intravenous antibiotics, and the lesion resolved leaving scars which caused cicatricial ectropion in all cases.Anthrax is a rare disease but should be considered in the differential diagnosis of ulcerative (and eschar forming) preseptal cellulitis with a history of contact with anthrax-infected animals or animal products.Furthermore, cicatrization of the eyelids, one of the sequelae of periocular cutaneous anthrax, should be addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Ophthalmology, College of Public Health and Medical Sciences, Jimma University, PO Box: 440, Jimma, Ethiopia. dryeshi@yahoo.com

ABSTRACT

Background: Anthrax is a zoonotic disease caused by Bacillus anthracis. Naturally occurring human infection is rare and is generally the result of contact with anthrax-infected animals or animal products.

Case presentation: We examined three patients who had contact with presumed anthrax-infected animal and/or its product and presented with preseptal cellulitis with a localized itchy erythematous papule of the eyelid and non-pitting periorbital edema, followed by ulceration and dark eschar formation. All the three patients responded to intravenous antibiotics, and the lesion resolved leaving scars which caused cicatricial ectropion in all cases.

Conclusion: Anthrax is a rare disease but should be considered in the differential diagnosis of ulcerative (and eschar forming) preseptal cellulitis with a history of contact with anthrax-infected animals or animal products. Furthermore, cicatrization of the eyelids, one of the sequelae of periocular cutaneous anthrax, should be addressed. Urgent case report to the local zoonotic disease and infection control body and other responsible authorities is recommended.

Show MeSH
Related in: MedlinePlus