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ANTRAKSwoolsorter’s disease, siberian ulcer,

ragsorter’s disease

Risna

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ETIOLOGI

Bacillus anthracis yang merupakan basilgram positif, non-motil dan bisa membentuk

spora (sporulasi)

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Clinical findings Symptoms and signs 1. Cutaneous anthrax

. !nhalational anthrax  bioterrorism

". #astrointestinal anthrax

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C$%&'$S &'%&*S

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1. Cutaneous anthrax  !ncubation period +eeks

%he initial lesion is an erythematous papule, often on an

exposed area of skin that esiculated and then ulcerated

and undergoes necrosis, ultimately progressing to a

purple to black schar

ainless  pain indicates secondary infection

%he surrounding area is edematous and esicular but

not purulent

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Clinical findings Cutaneous anthrax (cont.)

egional adenopathy, /

0eer 

alaise

2eadache

'ausea and omiting

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2. Inhalational anthrax 

%+o stages

Begins on aerage 13 days after exposure. &lthough a

longer incubation period of up to 4 +eeks

'onspecific iral-like symptoms

0eer 

alaise

2eadache

5yspnea

Cough

Congestion of the nose, throat

and larynx

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2. Inhalational anthrax (cont.)

%+o stages

 &nterior chest pain  is an early symptom of

mediastinitis. 6hithin hours to a fe+ days, progression

to the fulminant stage of infection occurs in +hich signs

and symptoms of sepsis predominate

5elirium, obtudation, or meningeal irritation suggest an

accopanying hemorrhagic meningitis". #astrointestinal anthrax /

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!'2&7&%!8' &'%&*S

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3. Gastrointestinal anthrax 

Symptoms begin -9 days after ingestion of meatcontaminated +ith anthrax spores

0eer 

5iffuse abdominal pain

ebound abdominal tenderness

:omiting

Constipation or diarrhea

mesis is blood-tinged or coffee-ground%he stool may be blood tinged or melenic

Bo+el perforation

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#&S%8!'%S%!'&7 &'%&*S

 &. Suatu edema berat padalengkungan duodenum padaintestinal anthrax  dengan suatupembesaran limfonodus ( diantara ;ari dokter bedah di atas ).

 B. Segmen usus yang samasetelah dibuka. %erdapat edema,nekrosis, dan mukosa hemoragik.Sebuah eschar  sentral ( padatanda panah ) dan tersisa nodulkecil yang mengelilingi pada lesicutaneus anthrax  

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Clinical findings 4. The oropharyngeal form of the

disease is characterized y!

7ocal lymphadenopathy

Cerical edema

5ysphagia

$pper respiratory tract obstruction

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5ifferential diagnosis

%ypes of anthrax 55

-Cutaneous anthrax  -Ecthyma gangrenosum, rat bite fever,ulceroglandular tularemia, plague,glanders, rickettsialpox, orf, cutaneous

mycobacterial infection

-Inhalational anthrax -mediastinitis

-Gastrointestinal anthrax -Boel obtruction, perforatesviscus,peritonitis, gastroenteritis, pepticulcer disease

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%reatment &ntimicrobial agents ecommended dosee

0irst-line agents - !iprofloxacin, " x #$$ mg daily orally or " x %$$ mg&'" hours intravenously (I)* +O!

- +ocycycline, '$$ mg every '" hours orally or I)

Second-line agents - moxicillin - x #$$ mg daily orally

- .enicillin G, " m/ every % hours intravenously

 &lternatie agents+ith in itro actiity

- 0ifampin, '$ mg&kg&d orally or intravenously

- !lindamycin, %#$12$$ mg every 3 hours orally&iv

- !larithromycin, #$$ mg tice daily

- Erythromycin, #$$ mg mg every 2 hours iv

- )ancomycin, ' g every '" hours

- Imipenem, #$$ mg every 2 hours iv

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8#'8S!S

!nhalation anthrax