title: Evaluation of clinical and serological findings for diagnosis of cutaneous anthrax infection after an outbreak.
abstract: OBJECTIVE
  Anthrax, caused by the bacterium Bacillus anthracis, is one of the oldest documented infectious diseases in both livestock and humans. We aimed to evaluate clinical findings and risk factors of patients with cutaneous anthrax infection and report anti-lethal factor (LF) IgG and anti-protective antigen (PA) IgG titers in the serologic diagnosis of disease.
  
  
  METHODS
  In this study, serum samples of 18 cutaneous anthrax patients were collected and anti-LF IgG and anti-PA IgG titers were measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Twelve (67%) males and 6 (33%) females, with a mean age of 36.06 ± 16.58 years were included in the study. Risk factors identified in the patient population studied were slaughtering (28%), flaying (56%), chopping meat (67%), burying diseased animal corpses (17%) and milking (6%) livestock. Black eschar formation (94%), pruritus (78%) and painful lymphadenopathy (61%) were first three common clinical signs and symptoms, respectively. Fourteen (78%) patients produced a positive IgG response against PA, 11 (61%) patients produced against LF. Three (17%) patients had no response to either antigen.
  
  
  CONCLUSIONS
  A detailed history of contact with sick animals or animal products along with clinical findings should be taken at the first step for the diagnosis of cutaneous anthrax infection. Serologic detection of anti-LF IgG and anti-PA IgG with ELISA may be useful auxillary method for establishing the diagnosis.
authors.affiliation: a Department of Dermatology , Ankara Polatlı State Hospital , Ankara , Turkey and.
authors.forename: Duygu
authors.initials: D
authors.lastname: Gulseren
authors.affiliation: b Department of Microbiology Reference Laboratory , Public Health Institution of Turkey , Ankara , Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Süzük-Yıldız
authors.affiliation: b Department of Microbiology Reference Laboratory , Public Health Institution of Turkey , Ankara , Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Çelebi
authors.affiliation: b Department of Microbiology Reference Laboratory , Public Health Institution of Turkey , Ankara , Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Kılıç
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture; D000818:Animals; D000881:Anthrax / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D000942:Antigens, Bacterial / Q000276:immunology*; D001427:Bacterial Toxins / Q000276:immunology*; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D019649:Food Industry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D014421:Turkey; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001427:Bacterial Toxins; D007074:Immunoglobulin G; C030325:anthrax toxin
keywords: Anthrax; diagnosis; outbreak; serology; skin