Repository of Research and Investigative Information

Repository of Research and Investigative Information

Kurdistan University of Medical Sciences

First Autochthonous Coinfected Anthrax in an Immunocompetent Patient

(2015) First Autochthonous Coinfected Anthrax in an Immunocompetent Patient. Case Reports in Medicine.

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Cutaneous anthrax has a mortality rate of 20 if no antibacterial treatment is applied. The clinical manifestations of cutaneous anthrax are obviously striking, but coinfection may produce atypical lesions and mask the clinical manifestations and proper laboratory diagnosis. Anthrax is known to be more common in the Middle East and Iran is one of the countries in which the zoonotic form of anthrax may still be encountered. We report a case of a 19-years-old male who used to apply Venetian ceruse on his skin. Venetian ceruse (also known as Spirits of Saturn) is an old cosmetic product used for skin whitening traditionally made from sheep's spinal cord. The patient referred to the Referral Laboratory, Mazandaran University of Medical Sciences, Sari, Iran, with atypical dermatosis, pronounced pain, and oedema of the affected tissue. It was confirmed by both conventional and molecular analysis that culture was a mixture of Bacillus anthracis and Trichophyton interdigitale. The patient was initially treated with ceftriaxone (1000 mg/day for two weeks), gentamicin (1.5-2 mg/kg/day), terbinafine (200 mg/week for one month), and 1 clotrimazole cream (5 weeks) two times per day which resulted in gradual improvement. No relapse could be detected after one-year follow-up. Anthrax infection might present a broader spectrum of symptoms than expected by clinicians. These unfamiliar characteristics may lead to delayed diagnosis, inadequate treatment, and higher mortality rate. Clinicians need to be aware of this issue in order to have successful management over this infection. © 2015 Parvaneh Afshar et al.

Item Type: Article
Keywords: ceftriaxone; clotrimazole; cosmetic; gentamicin; terbinafine, adult; anthrax; Article; Bacillus anthracis; dermatophytosis; drug dose increase; drug sensitivity; follow up; human; immunocompetence; male; mixed infection; mycosis; pain; priority journal; skin disease; skin edema; treatment outcome; treatment response; Trichophyton interdigitale; young adult
Journal or Publication Title: Case Reports in Medicine
Volume: 2015
Publisher: Hindawi Limited
Identification Number: 10.1155/2015/325093
ISSN: 16879627
Depositing User: مهندس جمال محمودپور

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