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Rationale:
- GI anthrax presents as a nonspecific gastrointestinal syndrome with nausea, vomiting, and malaise and progresses rapidly to
bloody diarrhea, acute abdomen, or sepsis.
- Mortality from GI anthrax is very high, and early diagnosis may prevent sickness and death.
- GI anthrax often occurs concomitantly with inhalational anthrax; therefore, rapid intervention in patients with inhalational
anthrax and signs of GI disease is essential.
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Evidence:
- GI anthrax progresses quickly from nausea, vomiting, and malaise to GI bleeding, acute abdomen, and in some cases massive
ascites (24; 31; 32).
- B. anthracis invades the submucosa of the lower GI tract to cause erosions and bleeding. In the Sverdlovsk outbreak, pathologic specimens
showed B. anthracis infiltration of the liver and intestinal mucosa. The small intestine contained numerous submucosal hematomas (29; 32).
- In the Sverdlovsk outbreak of inhalational anthrax, 39 of 42 patients had evidence of GI disease on pathology (29; 33).
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Comments:
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Barbara Robinson-Dunn, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Demetrios N. Kyriacou, MD, PhD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Niklas Mackler, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Sandro Cinti, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
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Anthrax
> Diagnosis
