title: Cutaneous anthrax associated with microangiopathic hemolytic anemia and coagulopathy in a 7-month-old infant.
abstract: A 7-month-old infant with cutaneous anthrax developed severe systemic illness despite early treatment with antibiotics. The infant displayed severe microangiopathic hemolytic anemia with renal involvement, coagulopathy, and hyponatremia. These findings are unusual with cutaneous anthrax, but have been described in illness resulting from spider toxin and may delay correct diagnosis. The systemic manifestations of the disease persisted for nearly a month despite corticosteroid therapy, but resolved.
authors.affiliation: Department of Pediatrics, New York University Medical Center, 550 First Ave, New York, NY 10016, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Freedman
authors.forename: Olubunmi
authors.initials: O
authors.lastname: Afonja
authors.forename: Mary Wu
authors.initials: MW
authors.lastname: Chang
authors.forename: Farzad
authors.initials: F
authors.lastname: Mostashari
authors.forename: Martin
authors.initials: M
authors.lastname: Blaser
authors.forename: Guillermo
authors.initials: G
authors.lastname: Perez-Perez
authors.forename: Herb
authors.initials: H
authors.lastname: Lazarus
authors.forename: Robert
authors.initials: R
authors.lastname: Schacht
authors.forename: Jane
authors.initials: J
authors.lastname: Guttenberg
authors.forename: Michael
authors.initials: M
authors.lastname: Traister
authors.forename: William
authors.initials: W
authors.lastname: Borkowsky
mesh_terms: D000743:Anemia, Hemolytic / Q000209:etiology*; D000881:Anthrax / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D001408:Bacillus anthracis / Q000302:isolation & purification*; D023482:Bioterrorism; D001850:Bone Diseases, Infectious / Q000175:diagnosis; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D004781:Environmental Exposure; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D007223:Infant; D008297:Male; D009519:New York City; D017192:Skin Diseases, Bacterial / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D018461:Soft Tissue Infections / Q000175:diagnosis; D001098:Spider Bites / Q000175:diagnosis; D013171:Spores, Bacterial / Q000302:isolation & purification; D013921:Thrombocytopenia / Q000209:etiology