A case report of inhalation anthrax acquired naturally.
A case report of inhalation anthrax acquired naturally.
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DOI：
10.1186/s13104-016-1955-0
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发表时间：
2016-03-03
影响因子：
1.8
通讯作者：
Bidaki, Majid Zare
中科院分区：
文献类型：
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作者：
Azarkar, Zohreh;Bidaki, Majid Zare
背景：炭疽病是由炭疽杆菌引起的人畜共患职业病，炭疽杆菌是一种杆状、不动的革兰氏阳性需氧菌，具有芽孢。炭疽病在人类中随机发生，发生频率低。大多数炭疽病例是通过接触受感染的动物或受污染的动物产品获得的。自从2001年生物孢子在美国被利用以来，这种古老的疾病变得特别重要。根据疾病的传播方式，临床表现分为三类：皮肤炭疽、呼吸道炭疽和胃肠道炭疽。呼吸道形式被认为是最致命和最罕见的炭疽形式，旨在表现出复杂和不寻常的表现。病例介绍：在本病例报告中，介绍了伊朗东南部自然获得的罕见吸入性炭疽病例。一位65岁的盲人男性，居住在农村地区，因呼吸道感染、发热、呼吸困难、食欲不振和肌痛入院。患者一周前接受门诊抗生素治疗。入院后，患者再次接受肺炎治疗，但治疗后无改善，患者出现败血症症状。放射学图像显示纵隔宽。从血液和痰培养中分离炭疽杆菌，并通过菌落形态、生化反应和PCR证实结果。治疗改为环丙沙星、克林霉素和青霉素。在炭疽治疗的第二天，病人并发黄疸，肝酶升高，血红蛋白，红细胞压积和血小板显着下降，尽管没有明显的出血，并并发呼吸窘迫和败血症，一周后死亡treatment.CONCLUSIONS：我们可以发现没有特定的接触与炭疽感染的病人。然而，由于位于地方病和地方病地区，因此建议通过接触受感染的空气传播的灰尘或未知的污染物进行接触。尽管在预防炭疽方面取得了许多进展，但仍然出现了一些罕见的呼吸道炭疽和复杂的炭疽病例。关于生物恐怖主义的威胁，必须提高医务人员对炭疽病临床症状、预防和治疗方法的敏感性。快速诊断和成功治疗这种感染的致命病例是至关重要的。
BACKGROUND: Anthrax is a zoonotic occupational disease caused by Bacillus anthracis, a rod-shaped immobile aerobic gram-positive bacteria with spore. Anthrax occurs in humans randomly and with low frequency. Most cases of anthrax are acquired through contact with infected animals or contaminated animal products. This old disease became particularly important since 2001 that the biological spores were exploited in America. Depending on the transmission method of the disease, clinical manifestations occur in three classes: Cutaneous, respiratory, and gastrointestinal anthrax. The respiratory form is considered as the most fatal and a rare form of anthrax intending to show complicated and unusual manifestations.CASE PRESENTATION: In this case report a rare case of inhalation anthrax acquired naturally in southeast of Iran is presented. A blind 65-year-old man, living in a rural area, was admitted with respiratory infection, fever, dyspnea, loss of appetite, and myalgia. The patient was treated with outpatient antibiotics a week ago. After admission, the patient was again treated for pneumonia, but there was no improvement despite treatment and the patient was suffering from septicemia symptoms. Radiographic images showed wide mediastinum. Bacillus anthracis was isolated from blood and sputum culture and the results were confirmed by colony morphology, biochemical reactions and PCR. The treatment was changed to ciprofloxacin, clindamycin, and penicillin. On the second day of anthrax treatment, the patient was complicated with jaundice, elevation of liver enzymes, and a significant drop in hemoglobin, hematocrit, and platelet despite lack of obvious bleeding and was complicated with respiratory distress and sepsis and died a week after treatment.CONCLUSIONS: We could discover no specific exposure associated with anthrax infection for this patient. However, due to being located in an endemic and enzootic area, it is proposed that the exposure occurred through contact with infected airborne dust or an unknown contaminated item. Despite many advances in preventing anthrax, still some rare cases of respiratory and complicated anthrax are emerging. With regard to the threat of bioterrorism, medical staff's sensitivity to the clinical syndrome, methods of prophylaxis and treatment of anthrax must be raised. Fast diagnosis and successful treatment the lethal cases of this infection are of utmost important.