Clinical characteristics of 21 cases with human cutaneous anthrax in Yan′an city, Shaanxi province

Abstract

Objective To investigate the epidemiology and clinical characteristics of 21 cases with human cutaneous anthrax. Methods The clinical manifestations and epidemic data of twenty-one human cutaneous anthrax cases from July to December in 2015 in Yan′an City, Shaanxi Province were reviewed. Their demographic data, epidemic features, clinical manifestations, laboratory results, treatment regimen and outcomes were retrospectively analyzed. Results All the 21 patients had previous contact history with the dead mules or donkeys before the onset of crater-like skin ulcer, and some of them presented with fever, headache, diarrhea and lymphadenoma. Gram-positive bacillus, which had squared ends and endospores, was found in the skin secretions of two patients and positive aerobic culture of spore-forming bacillus was found in one patient, with positive phage test and penicillin G susceptibility test. All patients cured after individualized penicillin treatment. Conclusions When the patient presents with crater-like skin ulcers and eschar after contacting with the dead livestock, anthrax infection should be carefully ruled out. Timely sample collection and etiological examination can help make the diagnosis of human cutaneous anthrax. Early administration of penicillin is important for infection control and disease cure. Early disease reporting and relevant knowledge propaganda are the key measures to prevent and control the transmission of the disease. Key words: Bacillus anthracis; Human cutaneous anthrax; Diagnosis; Treatment