Cutaneous Anthrax

 

– Toxic infection of herbivores due to Bacillus anthracis transmitted to humans by inoculation through the skin (contact with dead animals of coal, flies).

Common in tropical regions.

– There is also a pulmonary form, transmitted by inhalation and gastrointestinal form transmitted by ingestion of contaminated meat.

Clinical signs:

– Pruritic papule and vesicle moving towards a central ulceration. It is replaced by a black eschar surrounded by a large edema with lymphangitis, regional lymph nodes and / or general signs. Location in open areas (head, neck, limbs). Absence of pain.

– In the absence of early treatment, the risk of malignant edema extensive and sepsis.

Treatment:

Simple cutaneous anthrax (outpatient):

• Antibiotic treatment: phenoxymethylpenicillin (penicillin V) PO

Children less than one year: 250 mg / day in 4 divided doses for 7 to 10 days

Children from 1 to 5 years: 500 mg / day in 4 divided doses for 7 to 10 days

Children 6 to 12 years: 1 g / day in 4 divided doses for 7 to 10 days

Adult: 2 g / day in 4 divided doses for 7 to 10 days

In case of allergy to penicillin: doxycycline PO (except for the child under 8 years and pregnant or lactating women)

Children over 8 years and adults: 200 mg / day in 2 divided doses for 7 to 10 days or erythromycin PO

Child: 30 to 50 mg / kg / day divided in 2 or 3 doses for 7 to 10 days

Adult: 2 to 3 g / day divided in 2 or 3 doses for 7 to 10 days

• Do not excise the eschar. Daily dry dressings.

Cutaneous anthrax with extensive edema or generalized signs or reaching the head or neck (in hospital):

PPF or procaine benzylpenicillin IM

Children: 100 000 IU / kg / day in one or two injections

Adult: 4 MIU / day in one or two injections.

Take the oral route as soon as possible with phénoxyméthylpéniciline PO to complete 10 days of treatment:

Children less than one year: 250 mg / day in 4 divided doses

Children from 1 to 5 years: 500 mg / day in 4 divided doses

Children 6 to 12 years: 1 g / day in 4 divided doses

Adult: 2 g / day in 4 divided doses

In case of allergy to penicillin: chloramphenicol IV

Children: 100 mg / kg / day in 3 injections

Adults: 3 g / day in 3 injections

Take the oral route as soon as possible with chloramphenicol PO at the same doses to complete 10 days of treatment.

Prevention:

– Antibiotic prophylaxis of contacts:

doxycycline PO (200 mg / day for 6 weeks in adults, except pregnant women or nursing).

– Bury or incinerate the coal dead animals.

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