title: Cutaneous anthrax on eyelids.
abstract: BACKGROUND
  Ophthalmologists should be aware of the signs and symptoms of anthrax, although it is a rare disease in humans. We report our successful treatment of three patients with cutaneous lesions in the periorbital area.
  
  
  METHODS
  In this study, we report on the treatment of three female patients who were initially diagnosed as having preseptal cellulitis.
  
  
  METHODS
  Gram-positive robs were revealed in the microscopic examination of scrapings taken from the lesions. Bacillus anthracis was found in only two of the three scraping-material cultures. Intravenous penicillin G was administered in all cases. Black and necrotic eschar, which is characteristic of anthrax, developed on the eyelids of all three patients during treatment. At the final examinations of the patients after the completion of treatment, we recognized the development of cicatrisation, lagophthalmos, and slight ectropion in the upper eyelid of the first patient, and, in the second patient, restriction of upper eyelid movement and development of a corneal scar from exposure keratopathy and ectropion. The cutaneous lesions healed without any eyelid pathology in the third patient.
  
  
  CONCLUSIONS
  Although it is a rare disease in humans, anthrax should be considered in the differential diagnosis of preseptal and orbital cellulitis.
authors.affiliation: Department of Ophthalmology, Dicle University Medical Faculty, Diyarbakir, Turkey. ihsancaca@mynet.com
authors.forename: Ihsan
authors.initials: I
authors.lastname: Caça
authors.forename: Sevin Söker
authors.initials: SS
authors.lastname: Cakmak
authors.forename: Kaan
authors.initials: K
authors.lastname: Unlü
authors.forename: Yildirim Bayezit
authors.initials: YB
authors.lastname: Sakalar
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: KadiroGlu
mesh_terms: D000881:Anthrax / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002921:Cicatrix / Q000209:etiology; D003316:Corneal Diseases / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004774:Entropion / Q000209:etiology; D005141:Eyelid Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009336:Necrosis; D010400:Penicillin G / Q000627:therapeutic use*; D017192:Skin Diseases, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G