Anthrax

Alternative Names:

Wool sorter's disease; Ragpicker's disease

Symptoms:

Cutaneous anthrax: Blister or ulcer that later forms a black scab; usually has extensive surrounding swelling
Inhalation anthrax: Initial stage presents with fever, malaise, headache, cough, shortness of breath, and chest pain; Shock may occur in the second stage
Gastrointestinal anthrax: Nausea and vomiting (may include blood), anorexia, and bloody diarrhea

Signs and tests:

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The tests to diagnose anthrax depend on the type of disease suspected.

If cutaneous anthrax is suspected, a culture of the skin lesion will be done to identify the bacteria that causes anthrax.
If inhalational anthrax is suspected, a chest X-ray, blood cultures, sputum cultures, spinal tap for CSF culture, and gram stain may be performed. Samples may need to be sent to a special lab for more definitive testing, including PCR, immunofluorescence, and immunohistochemistry.

References:

Reissman DB, Whitney EA, Taylor TH Jr, et al. One-Year Health Assessment of Adult Survivors of Bacillus anthracis Infection.JAMA. 2004;291:1994-1998.

Inglesby TV, O'Toole T, Henderson DA, et al. Anthrax as a Biological Weapon, 2002. JAMA.160;2002;287:2236-2252.