Anthrax: Infection with symptoms on the skin and lungs

Anthrax is a rare but serious infectious disease caused by the spore-forming bacterium Bacillus anthracis. Cattle are particularly ill, but the spores are transmitted to humans through direct or indirect contact with sick animals. The disease may affect the skin, lungs and gastrointestinal tract. In most cases, the skin is affected and mild symptoms occur that disappear relatively quickly, but when the lungs and gastrointestinal tract are affected, serious complications may occur. Prompt treatment with antibiotics is therefore required to prevent serious health problems and death. Some preventive measures are possible to prevent anthrax.

  • Synonyms anthrax
  • Infectious disease epidemiology
  • Causes: Bacillus ” Bacillus anthracis
  • Symptoms of the skin, lungs, stomach and intestines
  • Diagnosis and examinations
  • Antibiotic treatment
  • Prognosis
  • Complications
  • Prevention anthrax

Synonyms anthrax

Anthrax is also known by these synonyms:

  • anthrax
  • cabbage bump
  • cabbage ulcer
  • anthrax

Infectious disease epidemiology

The disease occurs worldwide. Epidemics have been reported in Gambia, in North and South America and in southern and eastern Europe. The infection occurs most often among farmers, livestock keepers, butchers, veterinarians and traders in wool and animal skins. But travelers who travel to countries where many infected animals roam are also at a higher risk. The condition has no racial or sexual predilection. Anthrax is often related to the industrial sector and agriculture, and therefore young adults and middle-aged people are mainly affected.

Causes: Bacillus ” Bacillus anthracis

Bacillus anthracis , a bacillus, causes anthrax. The spores of these gram-positive bacilli are extremely strong and resistant to extreme temperatures and humidity, which is why they survive for decades. The organism is capable of producing a toxin. The transmission of the bacilli occurs through the skin (handling infected livestock or products thereof), the lungs (swallowing or inhaling spores) or consuming contaminated meat (stomach and intestines). When the spores enter the body, they are activated and anthrax bacteria are formed. The bacteria are then able to multiply and spread in the body. They then produce toxins, which may result in serious health problems. Anthrax is not a contagious disease.

Symptoms of the skin, lungs, stomach and intestines

The incubation period (time between contracting the infection and the appearance of symptoms) is one to ten days. The symptoms of anthrax depend on the type of infection. The disease affects the skin, lungs or gastrointestinal tract. Symptoms last from one day to more than two months.


Cutaneous anthrax is the most common (95%) and mildest form and occurs one to seven days after infection. This occurs after the spores end up in the skin through a wound, for example. The patient develops a small, erythematous, maculopapular rash, usually on the head, neck, forearms and hands. These initial painless skin lesions look like red spots that are sometimes itchy. The patient then develops painful blisters and skin ulcers on the face, neck, arms, or hands, with the formation of a black center and a crust around the ulcers. Most patients recover spontaneously within a few weeks, but sometimes swelling occurs around the blisters in combination with swollen lymph nodes, which makes the symptoms disappear more slowly. Thanks to good treatment, most patients survive the cutaneous form of the infectious disease.

Chest pain is a possible symptom of inhalational anthrax / Source: Pexels, Pixabay

Inhalation anthrax occurs after inhaling spores. The symptoms of inhalation anthrax often appear within a week of infection, but sometimes the signs of the disease do not appear until two months later. This form of anthrax is accompanied by high fever, chills, nausea, vomiting, stomach pain, muscle pain, malaise (a general ill feeling), headache, sweating, extreme fatigue, a dry cough, pain behind the breastbone (chest pain), shortness of breath, a bluish skin color (cyanosis), confusion or dizziness. Left untreated, the mortality rate from inhalation anthrax is very high, and even with treatment, about half of patients die.

Stomach and intestines

Gastrointestinal anthrax results from consuming undercooked, contaminated meat. The clinical features of this usually appear one to seven days after contraction and infection. The most common symptoms include loss of appetite, fever, chills, swollen lymph nodes in the neck or neck, sore throat, mouth sores, difficulty swallowing, hoarseness, nausea, vomiting, fainting, headache, flushing, severe gastroenteritis (gastrointestinal infection) , vomiting blood, abdominal pain, swelling of the abdomen (stomach) and bloody diarrhea. Blood poisoning by organic poison, shock and death are possible consequences.

Diagnosis and examinations

Physical and diagnostic examination

Anthrax is diagnosed by means of a skin biopsy of a skin lesion (removing a piece of skin lesion and having it examined microscopically) or by a blood test. If necessary, the doctor will perform an analysis of the spinal fluid or sputum (mucus).

Differential diagnosis

The doctor may confuse anthrax with the following conditions because the clinical picture is similar:

  • coccidioidomycosis (mild infection with symptoms on the skin and lungs)
  • the rat bite disease ( Streptococcus moniliformis, Spirillum minus )
  • diphtheria (bacterial infection with symptoms in the throat and respiratory tract)
  • ecthyma ( Pseudomonas aeruginosa (bacterial infection in weak people) and Staphylococcus infections: skin infection with pustules)
  • a Mycoplasma pneumonia
  • a subarachnoid hemorrhage (bleeding between meninges with headache, stiff neck and eye problems)
  • a viral pneumonia
  • gastroenteritis (a gastrointestinal infection)
  • the superior vena cava syndrome
  • histoplasmosis (fungal infection with lung problems)
  • glanders (Pseudomonas pseudomallei)
  • leprosy
  • meningitis (meningitis with headache, fever and stiff neck)
  • orf (viral skin infection due to contact with sheep or goats)
  • pleural effusion (fluid accumulation between the pleura and the lining of the lungs)
  • psittacosis (infectious disease due to contamination of birds)
  • rickettsia
  • tularemia (bacterial infection due to contamination of wild, infected animals)
  • typhoid (bacterial infection due to infected insect bite)

Antibiotic treatment

The doctor uses antibiotics to treat the infectious disease (penicillin, doxycycline and ciprofloxacin). For mild skin infections, oral (taken by mouth) therapy of two weeks to two months is indicated. For more serious infections, the doctor prescribes high doses of intravenous (through a vein) antibiotics, in combination with appropriate supportive care.


All types of anthrax are potentially very serious to fatal if left untreated. With prompt and effective antibiotic treatment, most patients recover well from the disease. The mortality rate with cutaneous anthrax is less than 1%, while with inhalation anthrax it fluctuates around 50% even with treatment.

With encephalitis, a complication of anthrax, a patient has a lot of headaches / Source: Geralt, Pixabay


Complications are rare with cutaneous anthrax, although secondary infections are possible. Gastrointestinal anthrax and inhalation anthrax sometimes lead to inflammation of the brain (encephalitis). This initially causes flu-like symptoms combined with an intense headache. However, later the patient develops more serious symptoms such as seizures, delirium (acute confusion with changes in brain function) and coma, sometimes resulting in death.

Prevention anthrax

Any infected animal that dies must be burned and the area in which that animal was housed must be disinfected. Mass vaccination of the animals prevents widespread infection, but an annual booster vaccination is necessary. A human vaccine is available for individuals at high risk for the disease. A preventive antibiotic treatment is also necessary after exposure to an infected animal.