title: Cutaneous anthrax in Southeast Anatolia of Turkey.
abstract: BACKGROUND
  Anthrax is a rare disease cause by Bacillus anthracis, a Gram-positive, rod-shaped endospore-forming capsuled bacterium. Anthrax is manifest in three primary forms: cutaneous, respiratory, and gastrointestinal. Cutaneous anthrax accounts for approximately 95% of all cases of anthrax in humans.
  
  
  OBJECTIVE
  In the present study, we evaluated the clinical diagnosis and treatment of cutaneous anthrax, a rare disease that nonetheless remains a serious healthcare problem in developing countries.
  
  
  METHODS
  The complete medical records of patients diagnosed with cutaneous anthrax between January 2001 and December 2012 were examined in a retrospective manner. Cutaneous anthrax was diagnosed by the identification of typical anthrax lesions and/or the presence of Gram-positive-capsuled bacillus after staining with Gram stain and methylen blue in pathology samples obtained from these lesions and the presence of characteristic scarring with a history of severe swelling, black eschar, and positive response to treatment form the basis of diagnosis in cases where cultures were negative for the presence of bacillus.
  
  
  RESULTS
  A total of 58 patients were admitted to the hospital with cutaneous anthrax between January 2001 and December 2012. This included 32 (55.2%) males and 26 (44.8%) females, with an age range of 15-82 years and a mean age of 38 ± 13.8 years. The incubation period for the infection ranged between 1 and 20 d (mean 3.7 ± 1.4 d). The most common symptoms at the time of hospital referral were swelling, redness, and black eschar of the skin. The most common lesion site was the hand and fingers (41.3%). Isolated of bacteria was used to diagnose the disease in six cases (23.8%), detection of Gram-positive bacillus in samples of characteristic lesion material was used in seven (28.5%) cases, and the presence of a characteristic lesion was the sole diagnostic criteria in 45 (77.6%) cases. Treatment consisted of penicillin G (12 cases), ampicillin-sulbactam (30 cases), Cefazolin (12 cases), or ciprofloxacin (4 cases).
  
  
  CONCLUSIONS
  Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology .
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.forename: Bilal
authors.initials: B
authors.lastname: Sula
authors.forename: Ozcan
authors.initials: O
authors.lastname: Devecı
authors.forename: Alicem
authors.initials: A
authors.lastname: Tekin
authors.forename: Fatma
authors.initials: F
authors.lastname: Bozkurt
authors.forename: Derya
authors.initials: D
authors.lastname: Ucmak
authors.forename: Şafak
authors.initials: Ş
authors.lastname: Kaya
authors.forename: Muhammed
authors.initials: M
authors.lastname: Bekcibasi
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Erkan
authors.forename: Celal
authors.initials: C
authors.lastname: Ayaz
authors.forename: Salih
authors.initials: S
authors.lastname: Hosoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000881:Anthrax / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Anthrax; complications; cutaneous; treatment