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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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Cicatricial ectropion.
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Figure 2: Cicatricial ectropion.

Mentions: With the clinical diagnosis of severe preseptal cellulitis/periocular cutaneous anthrax/, the patient was admitted to the Eye Ward and started on intravenous ceftriaxone 1gm BID and cloxacilline 500 mg IV QID for 2 weeks and then he was put on oral doxycycline 100 mg BID for 6 weeks. After 3 weeks the lesion resolved and visual acuity was 6/6. There was persistent cicatricial ectropion of the right eyelids (Figure 2) for which full thickness skin graft was done at 2 months of follow up. On further follow up at one year, there was lid disfigurement on the nasal part of both lids which warranted surgical correction.


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

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

Cicatricial ectropion.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Cicatricial ectropion.
Mentions: With the clinical diagnosis of severe preseptal cellulitis/periocular cutaneous anthrax/, the patient was admitted to the Eye Ward and started on intravenous ceftriaxone 1gm BID and cloxacilline 500 mg IV QID for 2 weeks and then he was put on oral doxycycline 100 mg BID for 6 weeks. After 3 weeks the lesion resolved and visual acuity was 6/6. There was persistent cicatricial ectropion of the right eyelids (Figure 2) for which full thickness skin graft was done at 2 months of follow up. On further follow up at one year, there was lid disfigurement on the nasal part of both lids which warranted surgical correction.

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